35 Reasons to Choose a Home Birth

From the “Healthy and Green Living” section at Care2.com is the blog post of 35 reasons to choose a home birth (and ensuing comments added some others, plus some counter-balancing opinion). Even if you don’t find that some — or even all — of the reasons are strong enough reasons for you to have a home birth, it does give you some food for thought about the benefits of home birth.

I won’t go down the line on these, but I will comment on #1:

Home birth is safer – Your house is a lot less likely to be a source of antibiotic-resistant bacteria, and it’s not full of sick people.

This is true, and here is an analogy for why antibiotic-resistant bacteria are more prone to be in the hospital (although, it is possible that you could get such an infection at home). Let’s say that your lawn was full of weeds, so you got an herbicide that promised to kill 99.9% of known weeds (but the 1 weed it couldn’t kill was dandelions). So, you get it and spray your yard, and, sure enough, all the weeds die… except the one dandelion in the middle of the yard. Now, you’ve got a bare patch of soil, and no competition for the dandelion seeds, so when the wind disperses them, they take root in the vacant soil and grow wildly, replicating themselves quickly because they have free reign in the otherwise barren soil. Hospitals strive for cleanliness and sterility, and there are effective treatments for bacteria and viruses. But they’re not perfect. And when they leave one germ with otherwise free range, that germ can proliferate and grow strong. Most healthy bodies can easily fight that infection (using the dandelion analogy — a gardener can go out and pull up the one dandelion in the otherwise barren field; but if the gardener is too sick to get out of bed, then s/he won’t catch the dandelion in time, so it replicates). But some healthy people can’t fight that infection very well, and since most people who are at the hospital are there because they’re in poor health in one way or another, they are more likely to contract a “super-bug.” But these “super-bugs” are not “super” in one way — when they have to fight and compete with other germs, they usually lose — which is why their numbers are so small as not to cause a problem in most places (unlike the prolific dandelions).  That’s why you’re less likely to catch a super-bug in a “dirty” home than in a “clean” hospital — the typical home has enough medium-bad germs to keep the really-bad germs in small enough numbers that they do not cause problems, even among people who are already sick, or have a cut in their skin, etc.

But, whether at home or at the hospital, make sure all birth attendants follow basic hygiene and hand-washing protocols to reduce the already-small risk of infection even further.

Diana at Birth at Home in Arizona also compiled her list of reasons to choose home birth.

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Happy Birthday, Seth!

Last year on this date, I published Seth’s birth story; now, here are the pictures that were taken right after he was born. Just a very slight recap of the birth story — because I had called the midwife when I had false labor and had her come too soon (from about 90 minutes away), I decided to wait to make sure it really was really for sure really labor before calling her again. So, I called her when my water broke… and Seth was born about an hour later. You do the math. 🙂 Plus, she had to arrange child care, so she got there about an hour after he was born.

Seth's First Picture (I'm talking to my husband, who missed everything!) :-(

Seth's First Picture (I'm talking to my husband, who missed everything!) 😦

Keith meets his little brother for the first time

Keith meets his little brother for the first time

03

I remember thinking that the baby was so small — probably about the same size as Keith was when he was born, which was 7 lb., 5 oz. Wrong!

The midwife looks over the baby

The midwife looks over the baby

Weighing my "itty bitty" -- nine pounds!

Weighing my "itty bitty" -- nine pounds!

The student midwife performs the neonatal assessment

The student midwife performs the neonatal assessment

The next birth? What about *this* birth?

Far too often, women put their wishes and dreams for birth on hold, promising to make changes for the next birth. Many women “plan” on having a natural childbirth (and I put that in quotes because too many women are like my oldest sister — their “plan” is assuming that they’ll show up to the hospital and have a natural labor and birth simply because women have been having unmedicated births for millenia), but then end up agreeing to an unnecessary induction (or other intervention), and regretfully let go of the dream or plan “this time… but next time will be different!”

But what about this birth? For one thing, it’s your only chance to give birth to this baby, which makes it important, even if you have other children. But for another, one intervention leads more easily to the next, and you may end up with a C-section for your first birth, and then find it difficult or impossible to have anything but a C-section for subsequent births. Click here to read an awesome post on “this birth”.

What’s the rush?

After a mom has reached the definition of “active labor” which includes that her cervix is over 4 cm (although many women can walk around for weeks at or over 4 cm dilation), if she ever goes longer than 2 hours without cervical change, she is likely to be diagnosed with “stalled labor” and wheeled off for a C-section. Apparently doctors think it is impossible for a woman to have a plateau in dilation and then start again, although many if not most midwives will recognize that this is a “variation of normal” and as long as everything is going along well with mother and baby (specifically, unless the mother requests a C-section, or the baby’s heartrate becomes “non-reassuring”, or something along those lines), midwives are content to wait.

If you haven’t seen it yet, you really need to watch this video clip, in which a doctor discusses a study they undertook at his hospital which looked at whether stalled or arrested labor is really an indication for C-section, in the absence of other factors. The short version is that as long as the baby was tolerating the labor, there was no need to rush — many moms in the “stalled labor” group went on to progress to full dilation and have a vaginal birth, sparing themselves and their babies from a C-section and recovery. Not only did moms as a group did better with vaginal birth than Cesarean (no surprise there!), but the vaginally-born babies were not harmed by their “extended stay” in utero. Actually, since the World Health Organization’s “Safe Motherhood” guidelines say that for normal, healthy women without complications, vaginal exams should be limited to every four hours, getting checked every hour or even every two hours may just be too much. I wonder how many moms have been told that they had stalled labor because they were checked every hour, when if they had had four hours between checks would have had more dilation. But too many women aren’t being given four hours — they’re being told that a plateau in dilation equals a Cesarean, and they believe what they are told.

This reminds me of what my Bradley instructor said probably every class, if not several times during class: “Is mom okay? Is baby okay? Then why can’t we wait?” Apparently, we can!

Oh, and for what it’s worth, my sister had a “stalled labor” in her second birth — she was at 6 cm dilation for 9 hours — and went on to have a normal vaginal birth (only pushed 5 minutes, too… but then, her longest pushing phase was 20 minutes), so stuff like this happens. And considering the benefits of vaginal birth over Cesarean for both mom and baby, as long as mom and baby are tolerating labor fine, why the rush?

It cost HOW MUCH??

Most of the birth blogs I read have talked about one or both of the birth-related articles that recently appeared in the LA Times and Time magazine. But Knitted in the Womb talked about one I hadn’t seen — from the Wall Street Journal, which talked about the hospital bill a woman received for her uncomplicated vaginal birth: $36,625! Although the total cost was negotiated down by the insurance company (about half off), she still had to pay a percentage of the bill, and had the nasty surprise of finding out that in addition to her annual deductible, her newborn had his own deductible to meet! [If you haven’t read the other articles, Knitted in the Womb has the links on her blog page.]

Not having had a hospital birth, it was definitely a curiosity to me to see certain aspects of this as-yet-unseen type of bill. It was a rude shock, but important for everyone to know, because even if you believe you don’t pay out of pocket, you really do, because all costs the insurance company incurs are passed along to their customers in one form or another. You’re paying for your coworker’s C-section. Fun, huh? [Oh, and don’t expect nationalized health care to improve matters — it will have all the (in)efficiency of Medicare and Medicaid, but on steroids.]

Back to the article — she writes that she requested an itemized statement to make sure she wasn’t billed for services she did not actually receive, and found that the sterile epidural tray cost $530.29.  Then writes,

An “Anes-cat 1-basic Outlying Area” was billed at $2,152.55. (I was told this was the cost of the hospital’s resources related to the epidural.) These items were in addition to the separate anesthesiologist’s charge of $1,530 for giving the epidural. Even though the pain-killing epidural shot felt priceless during my 20 hours of labor, I was amazed that its total cost could run so high. [In case you haven’t added that up, it’s over $4,000 for an epidural. And people think that childbirth classes and a doula, which can help you avoid needing an epidural, are expensive! The woman had to pay 15% of charges, so if these charges were the final charges her insurance company agreed to, then that’s about $630, which could cover both childbirth classes and a doula in many areas of the country.]

… the hospital listed a price of $2,382.92 for my recovery, when I hadn’t had a Caesarean section. It turned out the charge was for the 90 minutes I spent in the birthing room after my delivery. I recalled lying exhausted there while a kind nurse checked my vitals and cleaned me up. Important help, for sure, but was it really worth that much money? [This cost of recovery is nearly as much as I paid for my whole birth “package” with my midwives each pregnancy. The prenatal visits were anywhere from 30-90 minutes long, plus they came to my house for the birth and stayed during labor and for a few hours afterwards checking on me and making sure everything was cleaned up. Oh, and it included a labor doula, too!]

Interesting, to be sure. To those of you who have had hospital births, did you know these charges (or anything like it) beforehand? If you have insurance, did you ever see these kinds of bills, or only your out-of-pocket costs (whether home or hospital birth)? If you work in a hospital, are you aware of how much people are billed for services in your hospital, or is that “just something people in billing deal with”?

Why I love blogging

There are a lot of reasons I like blogging. I like connecting with like-minded (or not-so-like-minded) birth people all over the world. I read their blogs; they read my blog; we comment on each other’s blogs, and hopefully come to a greater knowledge and understanding of each other, of other people and situations, of birth in our own corner of the world, our own perspective, etc. I get to read interesting and insightful posts, and through blogs I come by more links that I’m glad I read, than I would have discovered otherwise.

But one of the reasons why I most like blogging — and why I blog so frequently and so much — is that it serves as a sort of online “memory bank” for me. Sure, bookmarks (on the computer or online) are helpful, but I use my blog as a big file folder that anyone can access. I’m not for sure when this will post, because I write up posts several days in advance sometimes, and then schedule them to post about the same time of day every day, and sometimes I will bump one post up or down, depending on what else I have in queue (for instance, if something time-sensitive comes to my attention, I will put it at the head of the line, and posts like this get bumped to the end). But, at the time I’m writing this, today somebody in an email group asked about a particular video on YouTube, so I just went into my WordPress Dashboard, pulled up the posts, and then filtered them by the category “birth video”, because the video she mentioned sounded familiar, and I was pretty sure that I had blogged about it before. It took maybe half a minute, and I had it! Is that cool, or what? 🙂

Many of the posts I write serve as detailed notes to myself about the links — what I got out of it, what I liked or disliked about it, etc., which also prompts my memory when I need to narrow down the list of posts I need to look through. In this case, I was looking for a twins birth video, but I wasn’t sure how I had worded the post, or if it was a post by itself or one of those “half-dozen links” posts, so I just filtered it down to the “birth videos” category, then looked at the tags to see which one(s) looked most promising. I got it on the second try.

This sort of thing has happened several times in the past several months — somebody will ask about something that sounds familiar, so I’ll check my blog, and *snap* there it is. Blogging is better than Delicious in this way too, because I can have a bunch of links in one post, whereas in Delicious, each link has to be separate. Sure, I can use the same tag to link them all into the same category, but it just feels “clunky” to me to do that. Ah, the internet! Love it!!

Baby Faith has passed on

Several weeks ago, I mentioned the blog of a young single mother whose baby had anencephaly. The baby’s name was Faith Hope, and she amazed the doctors and everyone around by living as long as she did — 93 days. Now, her struggles are over. If you want to read more from the mother, and relive the baby’s life as chronicled by her, from the time of the prenatal diagnosis through today (and more may be posted in the future), you can go to the blog and witness through the mother’s words and videos of what a baby with anencephaly is like. It’s quite a different picture from what you may “know” from medicine.

Not too many years ago, they were given the term “anencephalic monsters” and nothing was done for them — if you remember Ina May Gaskin’s Spiritual Midwifery, one of The Farm women had a baby with ancencephaly in the 1970s — baby Ira (his story and others are here) — and they expected the hospital to take care of him as best they could — palliative measures, if nothing else, but were shocked and horrified to find out several days later that they were witholding food and drink from him, and basically letting him die of neglect.

Many people have written hate-filled emails to Faith’s mom, Myah, going out of their way to torment and distress a loving mother, for her decision to love her baby and care for her as best she could, even knowing that her case was terminal. In that, she was no different from any other mother whose child has been given a poor prognosis, whether it’s some form of cancer, a deformed heart, or some other disease or condition that has a high or total lethality rate. Myah had to shut down the comment section of her blog, as well as her facebook account, and have friends check her emails so that she wouldn’t have to see the vile things people said to her and about both her and her baby. Despicable.

It was one such comment that actually was the reason I started thinking about premature babies being operated on without anesthesia back in the 70s and early 80s, which is why I used that as an example in the comment which triggered the stress reaction yesterday. The woman was not cruel (like some of the comments I’ve seen online), but said something like Myah was perhaps hypocritical in her refusal to believe what doctors were telling her about her baby, yet she continued to go to doctors for help when Faith had a problem. So I started thinking, “what do they really know about anencephaly?” I knew, from Baby Ira’s story, how babies with anencephaly were treated, and what they were thought of, in the 70s; and I wondered what research into anencephaly had happened in the past nearly 40 years which might what doctors knew. So, I did a Google Scholar search, and was absolutely flabbergasted by the paucity of research into anencephaly in recent times. Most of the studies were in the 50s, 60s and 70s; and I took a trip back through time, as I saw the multiple papers wondering what caused anencephaly, why there were so many cases of anencephaly, could it be something in the diet, and finally the triumphant paper that announced that too little folic acid was a culprit. It was kinda weird seeing that, because I was thinking, “DUH!” but, it was a big discovery back then. Some of the papers described certain physical characteristics of babies with anencephaly and other neural tube defects, and most of the rest discussed prenatal diagnosis and abortion — but there was nothing that I found that discussed brain function. What few papers there were from the 80s onward also did not address it; and most of the recent ones debated whether or not living anencephalic babies should be declared legally dead so their organs could be harvested. I looked at the titles of 150 different studies, and if they looked promising, I clicked on them. Of course, I was mostly limited to abstracts, but even in that, I could tell that most of the studies were not what I wanted.

I knew that in the 50s and 60s “doctors knew” that babies couldn’t feel pain until a few days after birth at least; and that up into the mid-80s, “doctors knew” that premature infants were not developed enough in the brain to register pain (which is why they felt comfortable operating on them without anesthesia). Now we know both of those assumptions were completely wrong, so you can understand why I wanted research that was more recent than those false assumptions. The assumptions of fetal/preemie/neonatal pain were based on studies of either animal brains or adult human brains, and it was assumed (logically, but perhaps incorrectly) that if this part of the brain does that in an adult, then if this part of the brain is not developed in a baby, then the baby cannot do that (whether the “that” is feel pain, hear, see, etc.). But the problem is that the brain is a fantastically amazing organ, with perhaps more ability to change and adapt than is currently believed. It is possible — and indeed many parents of babies with anencephaly will attest — that although these babies do not have the right parts of the brain intact, that what areas of the brain they do have take over for the functions of the areas of the brain they don’t have. There may be a difference between losing a section of brain and never having that section of brain to start with. Just as people born missing any other body part (like the Thalidomide debacle of the 60s in Europe, with babies born without hands, feet, arms, legs, or with their hands growing where their elbows should be, etc.), or losing a body part early in life, can adapt to their condition perhaps better than someone who is loses a limb in adulthood. I saw a story of a woman who lost both her arms when she was about 3 (she grabbed a major electical wire and burned her arms off), and she learned to do everything she needed with her feet — she even gave her boys a haircut using scissors!! But it’s extremely hard for an adult who loses his right hand to learn to write with his left, much less do more intricate, detailed, or demanding work.

So, I was very disappointed with the lack of research into actually helping these babies, or looking at what they could actually do, rather than just saying, “Nope. Won’t work. And we’ve got heaps of dusty old studies from 50 years ago to prove it.”

Wow, I’ve chased a lot of rabbit trails in this post!

So, long story short — baby Faith lived 3 months, and was loved by her mother every minute of her life. Not only did she live much longer than doctors predicted, but she was able to do more than her doctors expected. Doctors don’t know everything, particularly when the studies are few and far between, and are not particularly up-to-date. Perhaps if such babies were actually studied to see what they really could do, rather than just dogmatically saying, “impossible” and then not trying, then maybe we would find out that mothers aren’t lying or crazy when they say that their anencephalic babies are doing what doctors have prejudicially declared they couldn’t.

I know that the prognosis is not good. Even if such studies are undertaken, I don’t expect babies with anencephaly to live long lives nor develop exactly like normal babies. But surely we can do better than letting them die of neglect or lack of medical care (which is still happening today — many doctors will outright refuse or are hesitant to do small things like give these babies oxygen if they’re having difficulty breathing). Surely we can do better.