Is Homebirth A Green Idea? A Thoughtful Review (Part 2)

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.

The whole family is involved in the newborn exam.

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?

Victoria

 

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.

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18 Responses to Is Homebirth A Green Idea? A Thoughtful Review (Part 2)

  1. Pingback: Is Homebirth A Green Idea? A Thoughtful Review (Part 1) | Green Idea Reviews

  2. Marlo says:

    We are done with having our babies and my husband wouldn’t consider home birth. However, we had 3 wonderful natural births at the hospital. Thanks for the review. I think many people need to hear this. We are far too removed from the idea that God built our bodies for childbirth and that we can do it on our own without intervention!

  3. Rene S says:

    I don’t have children, but I found both parts of this series interesting and informative. Thank you for sharing this with everyone.

  4. Dana says:

    Once again, perfectly put. I would remind those moms going for home birth to think about child care during their labor and birth. If you have other littles ones, be sure you have a friend, grand parent or neighbor come to the home to tend to the other siblings. The midwives and the father will be preoccupied helping the mom. It’s just nice to have the extra hands. Love this post! Thanks again for helping to spread the word of happy and safe homebirthing.

    • Victoria says:

      Yes! Good tips Dana. We have always had a good friend on call who is responsible for the children so that my husband and I can focus only on the work at hand.

  5. I love the silly questions part! isn’t it the truth though. We actually chose not to tell certain family members as there was just no way they would understand.

    love the big belly pic!

    • Victoria says:

      Yes, we don’t talk about homebirth with most of our family members. I’m hoping these articles may be a non-confrontational way to help them understand better…

  6. Sylvia says:

    We had our first home birth in 1985. As far as I’m concerned there is no better place to have a baby! Great informative post!

  7. I have had all seven of my children at home and would not have done it any other way. My last two babies were born in the water (water births) and they were amazing. I have had friends that have had to have children at the hospital and have had good experiences, but so much of that depends on the doctor you have and the policies of the hospital. I know that home birth is not an option for everyone, but I would encourage anyone that is naturally minded to at least check into it.

  8. Rachel R. says:

    Our babies were all born in our bathtubs – no tub rental. (The first one wasn’t intended that way – a recent move threw a wrench into our plans – but it worked out fine.)

    As they’re weighing their options, people also should be aware that things vary from state to state. Here in VA, midwives are not permitted to carry drugs at all (like pitocin for potential hemorrhage). (I think the doctors did this on purpose, when midwives were fighting for licensure rights, because I think they *want* homebirth to be as dangerous as possible. Stupid politics.) For us, the benefits of homebirth still outweigh the alternatives, but as everyone weighs risks and benefits a bit differently, readers will want to know that what midwives can/can’t legally do is not the same in every state.

    • Victoria says:

      For my first I labored in the big roomy bathtub in our apartment, but ended up delivering in bed. My second came so fast, we filled the bathtub, but she came so fast I couldn’t make it to the bathroom to get in. For my third, we were in a small rental house with a tiny bathtub (I lasted 2 contractions in there before I got right back out), and no room to put a rental tub. I like the idea of a water birth, it just never worked out.

      Thanks for reminding us that midwife policies vary by state! It may be because I delivered with a Certified Nurse Midwife (CNM) that she carries Pitocin, etc. I know that CNMs are able to write prescriptions where I believe other types of midwives cannot. PLEASE EVERYONE: Do your own research about the birth options in your state, and ensure both you and your partner feel comfortable!

  9. Pingback: Placenta Encapsulation Review – How, Why, and Does it Work? | Green Idea Reviews

  10. Lisa Lynn says:

    Awesome! Thanks so much for sharing your post on Wildcrafting Wednesday! I hope to see you again today!
    http://www.theselfsufficienthomeacre.com/2013/05/wildcrafting-wednesday-18.html

  11. Melissa Ryan says:

    You make some very good points in this. I worry about the mess as well, but ultimately just felt more comfortable in the hospital in case there was any complications. But until the very end of my labor at 70 hours in with no progress, I was going all natural/med free. I delivered at a great hospital that completely respected my wishes and actually has midwives on staff! They were great about never pushing pitocin on me or an epidural and when I did eventually get those, it was my choice because my son was having signs of distress and I had been awake 88 straight hours and just couldn’t keep going. I hope next time to go completely med free and get the natural birth I have been dreaming of.

    Thanks for linking up at the Tuesday Baby link up. Hope you will link up with us again!

    • Victoria says:

      Melissa, you are amazing! I’m so glad your baby arrived safely and you had a team of midwives supporting you. Best wishes for next time!

  12. Pingback: Chatting about Homebirth with the Preparedness Radio Network! | Green Idea Reviews

  13. Ms Lottie says:

    I live in New Zealand (and am a midwife) where maternity care is free. Many midwives work out in the community as LMC’s (lead maternity carers) and will see you through your pregnancy, look after you for your birth either at home or hospital (they have access agreements to use the facility) and then see you for a month after birth. It doesn’t cost the mother anything, no matter what birth she chooses (unless she wants an elective c/section, then she has to choose an OB as her LMC, and they charge extra on top of what the government pays them).

    We can write prescriptions for medications required during pregnancy, labour and birth and postnatally, we carry emergency drugs and equipment and we have a backup midwife who attends home births as a ‘second pair of hands’.

    Free maternity care means all women and babies get the same high-quality care and the best start to life for the baby.

    But I don’t know why they don’t encourage more home births here for the uncomplicated, because it’s much cheaper for the healthcare system (and therefore the taxpayer). For a home birth, they pay the LMC the birth fee plus a small home birth fee. For a hospital birth, they pay the LMC the birth fee, plus they have to pay the hospital a facility fee, plus they are paying the wages of the hospital midwives, health care assistants, cleaners, cooks, admin staff…..

    So homebirth is greener in that sense for sure. I also typically use much less disposable goods (underpads, wipes etc) when I’m attending a home birth – greener again. Breastfeeding stats are usually a bit better for homebirths (although we have very good rates in NZ anyway). And someone mentioned the lack of hospital germs, therefore decreased rates of hospital induced infections and the consequent cost of treating them.

    Don’t get me wrong – the hospitals are great and do a much needed job. I work a couple of shifts a week at our local maternity unit and I don’t want to talk myself out of a job 😉 But for the community as a whole, an increase in homebirth rates would be a good thing.

    And just in case you are interested, I had one baby in hospital via ventouse (vacuum extraction) after a transfer from labouring at home (he got a bit stuck during the pushing phase) and then the next one at home in the birth pool.

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