mid·wife /ˈmidˌwīf/ — A person trained to assist women in childbirth
My midwife is a man. I’m guessing that most of you have never heard of a male midwife, but seriously you guys – my midwife rocks. He has been delivering babies in this rural county that I live in since 1983 – that’s 30 years! That’s almost as long as I’ve been alive, which means he has a great amount of experience, but he isn’t so old that he’s antiquated and out of touch with current technology and research. His wife (and now full time birth assistant) became a nurse in 1976 and has worked in various nursing fields since then (including L&D and NICU). Most days you’ll find them sailing on the local reservoir, having a drink and enjoying life — that is when they’re not busy volunteering for the local ambulance crew (he is a Certified EMT-I), mountain rescue team, and delivering area babies!
I consider childbirth to be a beautiful, sacred, and natural sequence of love. In my practice, I strive to facilitate the type of birth experience that parents most desire. I honor families and try to individualize my care. l believe that it is very important for people to be clear about why they want a home birth. Also, l believe that people should have good information about their choices of care providers so that they can make a decision that feels good and works for them.
Bill used to deliver 50+ babies a year, but now he only takes on about half that so that he has more free time. From 37 weeks and onward in a patient’s pregnancy, he is on call and in the area, and those final weekly visits will be done at my home. The visits from now until then are done at his house, which is about 20 minutes north of here and located along a beautiful river. Click here for a photo I took in June while walking up the sidewalk to my 12w appointment. Pretty awesome, eh?! He has delivered adult friends of mine 30 years ago and the babies of friends of mine (including a breech baby) in the past few years, all comfortably in their own homes. I feel 100% confident about our decision to go with a planned midwife assisted home birth this time around.
Hospital Birth or Home Birth?
For those of you who are newer readers, we had a midwife assisted hospital birth with Stella, and I used the HypnoBabies program as our pain management technique. Our birth preferences were followed to a T, and it was an absolutely wonderful birth experience. The entire thing took place in under 5 hours (they said it would have been under 3 if she has been positioned correctly!), so it was a bit of a whirlwind, but things went well.
Even though we had such a good experience last time, I still knew that I really wanted to attempt a home waterbirth if we were ever blessed to conceive a second child. I had lobbied for this with #1, but it made my husband too nervous, so we compromised on the midwife assisted hospital birth. I say “compromised” because at the time, all my husband knew about birth was what he’d seen on TV – screaming women asking for pain meds, and OBs jumping in at the last minute to grab the baby. This was not my ideal birth experience. Charlie thought I was crazy when I said I was planning on using self-hypnosis techniques for pain management and using a Midwife for my care, but he definitely came around to the idea.
When I found out we were expecting again, one of the first things I did was email Bill to set up an initial consult. I knew Charlie would take some convincing, and I wanted to give him plenty of time to come around to the idea of home birth. When I was about 6 weeks along, we had a two hour meeting with Bill and his wife, and it was a great time for Charlie to ask any and all questions he had about safety, transfers, medications, experience, etc. They also gave us a big packet of information about each of them, the practice, the protocols, my personal patient history (including asking for a written account of my previous birth story), etc. It was all very through, and I think that impressed Charlie. On the drive home I asked him his opinion about it, and he said he needed time. I proceeded to bite my tongue for about two weeks before saying a single word about it again to him, and when I asked him again about it, he said something along the lines of “well obviously it’s what you want, so I guess it’s what we’re going to do.” In my husband’s language, that means he was acquiescing because he felt more comfortable with it — though when I told him that yes, I do plan on renting a birthing tub, he called me “hippy dippy” – because apparently birthing your baby in the water is something only hippies do. 🙂
Reasons I Chose Home Birth
There are as many reasons to want different types of birth experiences as there are women, but here are a few of my reasons for choosing to plan on a midwife assisted home birth for baby #2. The reasons are all sort of intertwined, so bear with me.
Less Stress – Stressing about when to go to the hospital last time was honestly one of the hardest parts of my birth with Stella. We live 30 miles away from the hospital, and I was so afraid of getting there too early and having unnecessary and unwanted interventions heaped upon me that we maybe ended up cutting it a little too close! (I was fully dilated & effaced and ready to push when I walked in the door at midnight.) Also, riding in the car being in transition / being fully dilated and having contractions? NOT FUN.
More Choices – This applies to many different aspects of the birth experience, including but not limited to:
- The option to eat food if I so desire. I didn’t last time, but I think that’s because it went so fast!
- I want to wear whatever clothing I feel comfortable in – not necessarily something that works with an IV line, etc. I was naked last time, and I’m guessing I will be this time, but somehow that feels more comfortable in your own home!
- I’d like to have the freedom to try any different birth position that feels good to me at the time. My coworker just had her baby at the same hospital we went to with Stella, and the nurses spent the entire time she was in transition criticizing her positioning choices (like standing and holding the bar over the toilet in the bathroom). I want providers surrounding me who understand the benefit of different positions and are open to letting me try them!
- Water birth! My hospital doesn’t allow it (they have 1 tub you have to hope is available and you can labor it in only).
Respect for My Choices – There are midwives and OBs who fall on all ends of the spectrum of this, and unfortunately too many providers say one thing when you’re at your prenatal appointment and another thing in the heat of the moment.
- I love knowing that there is no hoping that the midwife or OB on call when my birthing time begins is the one who most agrees with my birthing philosophy (thankfully that was the case last time, but that only had a 20% chance of happening!). This time I will know it’s Bill who will be there when I call, I know his proven track record for supporting birthing mothers and their choices whenever possible, and that makes me feel great!
- It’s also comforting to know that Bill and his wife will have most definitely read my birth plan and be on board with my choices (like no eye ointment / VitK shot / HepB shot / etc) and I won’t feel like I have to be vigilant to ensure those things don’t happen without my consent anyway.
Safer – Yes, for low risk pregnancies, planned midwife assisted home birth is safer than a hospital birth, not the least of which is because it’s easier to avoid the cascade of interventions that often happen in a hospital setting. In a recent study done in Canada, it was determined that the rate of perinatal death per 1000 births was .35 for planned midwife assisted homebirths – significantly less than the .57 among hospital midwife births and .64 for physician attended hospital births. Childbirth is a natural part of life – not a medical “condition” as doctors and hospitals have been trained to think of it as.
Cost – We have maternity coverage, but we have a high deductible plan thanks to having a crazy expensive individual health insurance policy. Basically, we have a $5,000 individual deductible, plus we pay 30% coinsurance after that up to $12,500. This means that an uncomplicated, non-medicated hospital birth (like I had last time) would cost us nearly $8,000 — but a home birth is going to cost us only $4,000 for all of my prenatal, birthing, and postnatal care. Also, home birth is covered by my insurance (yes – this was a pleasant surprise), so if we need to transfer for any reason, at least the midwife fees would go towards our deductible anyway!
So there ya go… my synopsis on why I am super crazy incredibly over-the-moon excited about our birthing plan this time around. Yes, I had an awesome experience with Stella, but the home waterbirth was the one missing key to the puzzle, and I would love to get to experience that this time!
How about you? How did you choose the type of birth experience you were hoping for? Did you plan way ahead like me, or did you just wing it? Do you have any other questions about home birth that I might be able to answer?