In Part 1 of my Review of Homebirth as a Green Idea, I talked about the good and bad aspects of homebirthing, and discussed how I decided that home birth delivery was right for me. Today, I want to share additional information on why homebirthing is a Green Idea, how homebirth works, and more of what to expect if you decide homebirth is right for your family.
Note: this review is intended to explore the GREEN side of homebirth. I do not want to begin a debate on the safety of homebirth. Numerous studies have show equivalent safety rates when comparing home and hospital births (source). Of course, it is YOUR responsibility to do your own research and decide if homebirth is right for you. I will delete any comments debating the safety of homebirth, only because this is not the right forum for that discussion.
How is Homebirth a Green Idea?
Childbirth is a natural process that has been happening for all of time. When the baby is ready, the baby comes. Nothing is needed but a pregnant mama. This may be oversimplifying things, but I would suggest that childbirth has now been complicated to an environmentally damaging extent.
In the past (and today during most homebirths) the mother is left to quietly labor. She must be able to do her work in peace, alone. During my homebirths the midwives have spent most of the time in a different room, coming in to check on me and the baby every 20 minutes or so while I labor. This “undisturbed birthing” allows all the natural hormones to do their work:“Undisturbed birth represents the smoothest hormonal orchestration of the birth process, and therefore the easiest transition possible; physiologically, hormonally, psychologically, and emotionally, from pregnancy and birth to new motherhood and lactation, for each woman. When a mother’s hormonal orchestration is undisturbed, her baby’s safety is also enhanced, not only during labor and delivery, but also in the critical postnatal transition from womb to world.” (Buckley S. Gentle birth, gentle mothering: a doctor’s guide to natural childbirth and early parenting choices. Celestial Arts 2009. pp.97)
Today’s conventional hospital births take a mother out of her home environment and bombard her with many unnecessary interventions. (Change of location, change of clothing, IV fluids, imitation hormones, narcotic drugs, strange room, strange people, many interruptions). All of these things have a strong potential to derail the natural birthing process and require additional unnatural interventions to keep it going. Many of these additional interventions introduce greater risk to mama and baby and may inhibit post birth bonding and initiation of breastfeeding (the ultimate Green Idea!). This is the cascade of interventions.
So, what is a midwife, anyway?
A homebirthing mama is almost always attended by a midwife. Although in-hospital midwifery practices are becoming more common, I’ve been surprised by how many people are not familiar with modern midwifery. It seems many folks associate midwives with pioneer days or even biblical times. I even had one person ask me if you pay the midwife with chickens!
Today’s midwives are specialists in normal pregnancy. While an OB will tell you that birth is normal only in retrospect (or something like that), midwives assume all is well until they see something that indicates otherwise. Said another way, the doctor intervenes in the natural process to ensure nothing goes wrong, while the midwife only intervenes if something does go wrong. See below for a chart detailing the midwife model of care vs the medical model of care.
How does homebirth work?
Typically the mama has prenatal visits with the same midwife throughout her pregnancy either at her home, or at the midwife’s office. When the time comes for the baby to be born, the family alerts the midwife, who travels to the birthing mama’s home. The midwife observes the mama in labor, and uses intermittent electronic monitoring to ensure the baby is doing well. The mama is encouraged to birth in any position or location that works best for her, providing everyone remains safe. The midwife is mainly hands off, unless her intervention is needed for the safety of the baby. As the baby is born it is given directly to the mother: it’s health and first APGAR scores are assessed while babe is in mother’s arms.
Breastfeeding is encouraged almost immediately. The umbilical cord is generally left intact until after the placenta naturally delivers. Often the new family is given some alone time with the new babe to encourage bonding (this is often the time when siblings who were waiting in another room are introduced to the new family member). The midwife performs a full physical exam on the newborn, including height and weight. The baby is generally NOT washed, or cleaned up in any way by the midwife. The assumption here is that the vernix and any bacteria acquired from the birth canal is healthy for the babe and should be left alone. The midwife also examines the mama: ensuring bleeding is under control, repairing any tears, and administering drugs or herbal remedies as necessary.
What equipment does the midwife have? What if you need stitches?
The midwife and the birthing family work together to ensure all the necessary supplies are collected for the birth. Typically, the midwife will provide the family with a list of things they are responsible for. These include things like bed sheets, bath towels, receiving blankets, paper towels, flashlight, trash bags, and a “birth kit”. The birth kit is ordered from a birth supply company and has medical supplies like sterile gloves, gauze, alcohol wipes, a cord clamp, chux pads, feminine napkins, and that sexy one-size-fits-all mesh underwear.
The midwife brings more permanent medical supplies like sutures, syringes, drugs (like Pitocin or antibiotics), IV supplies, oxygen and other resuscitation gear. She also brings equipment like the handheld doppler, stethoscope blood pressure cuff, and baby scale. By the time the midwife arrives, your home has the same amount of medical equipment as any birthing center or hospital room. The only thing you’re missing is the operating room.
What about the mess?
People seem to be very concerned about the mess, perhaps imagining blood splashing all over the bedroom. Of course birth can be messy and bloody, but not any more so than at a hospital birth. For our births, we have made up the bed with a waterproof sheet topped with a set of old sheets that we don’t care so much about. We supply the midwives with a pile of what I call the “dog towels”. You know – the old towels you use to wash the dog or the car because they are already old and stained. During delivery the midwives use “chux” pads under the mama to catch as much mess as possible. (This is the same as the large underpads they use in the hospital).
After the birth is over, the bed can easily be stripped and the messy sheets and towels put straight into the washing machine – typically the midwife or her assistant does this for you. A small amount of peroxide based stain remover does wonders on removing the blood completely, especially if it has not yet dried. In my experience, hydrogen peroxide also takes wayward blood spots out of cream colored carpet beautifully.
Other silly questions I’ve been asked:
- Are you crazy? No, I’ve done my homework and feel comfortable that this is the right choice for me. But if your first question is about my sanity, then you’re likely not open to learning more, are you?
- Do they have epidurals at home? Epidurals can only be administered in a hospital setting by an anesthesiologist But I wanted a natural birth, so I wasn’t planning on an epidural anyway.
- What happens if something goes wrong? We go straight to the hospital, of course!
- How do you pay the midwife? She takes personal checks, and can work out a payment plan if necessary. Some midwives also know how to bill your insurance company. Other are willing to barter if you can offer something she needs (a new website or some carpentry work perhaps?)
- So you’ll have a waterbirth? This seems to be the trend in YouTube videos, doesn’t it? But no, not all homebirths are waterbirths. None of mine were — renting that pool is expensive!
You want to learn more? Here’s some links to resources I’ve used and love:
The Business of Being Born – a great documentary on the medical model of care in America, and why our C-section rate is going out of control. Available on Netflix.
Your Best Birth: Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience: An easy read with information on the pros and cons of typical birth interventions. From the folks who did the Business of Being Born Documentary.
Ina May’s Guide to Childbirth: another book from America’s wisest midwife. A great resource for info on natural birth and how to achieve it.
Husband-Coached Childbirth (Fifth Edition): The Bradley Method of Natural Childbirth: my husband and I used the Bradley Method pain management techniques during my labors and they WORK!
Overall, homebirth is right for me and my family. I can’t imagine having a baby any other way. Laboring and delivering at home, in my bed, with only my family and midwife friends is natural and empowering. I encourage you to learn as much as you can about your options prior to delivery. Childbirth is a life changing experience that you will never forget, and the way the process unfolds DOES matter!
Do you have any other questions about homebirth? Or perhaps some homebirth information I’ve left out that you think is important to share?
Reminder: this review is intended to explore the GREEN side of homebirth. I do not want to begin a debate on the safety of homebirth. Numerous studies have show equivalent safety rates when comparing home and hospital births (source). Of course, it is YOUR responsibility to do your own research and decide if homebirth is right for you. I will delete any comments debating the safety of homebirth, only because this is not the right forum for that discussion.