September 22 – September 28: 14 Weeks 0 Days – 14 Weeks 6 Days.
Proviso: This is not meant to disparage home birth, it’s a post about my personal process of choosing where plan to have my own birth. If you’re planning a home birth or had a home birth, I think that’s amazing!
One of my friends pointed out that outside of the yoga community (and other similar communities), you don’t really get the question, “What type of birth are you having?” Outside these certain communities it is assumed that you’ll go to the hospital and do whatever you need to do to end up with a happy, healthy baby and mother. Before I was pregnant I asked countless women this question. Now that I’m pregnant, answering this question makes me cringe. It seems to presuppose that I’ll have an interesting answer like a orgasmic-hypno-underwater-homebirth, and I find myself answering, “Oh, just a hospital birth.” Just. As if the birth of my child is diminished at all because it’s going to happen in a hospital.
The idea of giving birth in the comfort and relaxation of home with a big birth tub to labor in, dimmed lights, and a yard to walk around in appeals to me. Having a midwife who is on my payroll rather that the hospital’s and the insurance company’s makes a lot of sense to me. It would be great to not be on a clock tick-tocking down to being coerced into getting interventions because my labor is longer than is convenient. But at the end of the day, between the possibility that I could have a seizure due to my epilepsy and a comparison the mortality rates of hospital birth versus home births in the USA, the hospital won out for me (granted, there’s ongoing and vehement debate about the statistics around home birth versus hospital birth).
I was feeling bummed about it though—it felt like I was making some big trade-offs. That was before I had my first appointment and tour of the labor and delivery ward at the hospital I plan to give birth at.
I’ve never seen someone give birth. I’ve read books that advocate for home birth, and they describe hospital birth as quite an ordeal. It’s bright, loud, unfriendly, coercive, and you’re all but strapped to the bed for the convenience of the healthcare providers. I chose Saint Luke’s Hospital in San Francisco because they employ nurse-midwives to attend the low-risk pregnancies and are known for having a low intervention philosophy. They also have a low Cesarian rate, which is a good sign. Still, I wasn’t expecting it to be much better than what I’d read about. Obviously I haven’t given birth at Saint Luke’s yet, so I can’t know for sure how it will pan out, but from what they’ve told me and what I’ve seen, it couldn’t be more different from the horror show the books I’ve read have painted hospital birth to be.
When we walked into the labor and delivery room, it was like small hotel room with its own private bathroom with a shower. Most of the medical equipment was hidden behind an accordion wall. The overhead fluorescent lights were off and the room was softly lit by a small bedside lamp. Apparently I can even bring my own LED candles or Christmas lights if I’d prefer those for lighting. They have a squat bar, birthing ball, and birthing chair (whatever that is) at my disposal so I can give birth in any position my body calls for. The monitoring equipment they use is waterproof so that I can use the shower throughout labor. I’m allowed to eat at will as long as I haven’t had an epidural and am not at high risk for surgery. All of the staff members we met (both midwives and OB’s), welcomed laboring mothers handing them a page of individualized birth preferences upon arrival and seemed genuinely supportive of low-intervention birth. They say women are not on the clock when they get there, and can take as long as they need to labor (although, I’m sure there are limitations on that). They are so supportive of having doulas present, that they even host a Meet Local Doulas night once a month.
I’ve been told time and again that home birth midwives provide exceptional prenatal care, which I’m sure is true, but I’m really looking forward to what Saint Luke’s has to offer. They have the option of doing group prenatal care (instead of one-on-one appointments) with a consistent cohort of expecting mamas who have a similar due date. You see the same women every time so you have a support group to go through pregnancy with. Richard and I have zero family in the area, so having more local connections—especially ones going through the same challenges at the same time—is so, so, so valuable to me.
Now I’m excited about giving birth in a hospital. Saint Luke’s seems to have the exact mix of support and empowerment that I want. Of course I know that even at a progressive hospital at Saint Luke’s there can be issues that may unnecessarily compromise my birth preferences, but for now it feels amazing to actually be excited about the experience I’m going to have instead of feeling like I’m compromising!
Update: Now 30 weeks pregnant, I am more confident and comfortable than ever with my choice to give birth in a hospital. Especially since I’m planning to labor at home for as long as possible, I feel like I’ll be getting the best of both worlds. I’ve been telling people I’m planning to have a “natural birth” or a “low-intervention birth,” but neither of those labels felt quite right. This week (30 weeks pregnant), a friend pointed me to an article called Conscious Birthing, which just so happens to be written by one of my doulas, Britt Fohrman. I loved what she had to say:
I used to focus more on “natural birth” but after years of attending all sorts of births, I started to see how limiting that focus was. Any birth can be conscious, and beyond mom and baby being healthy, its how we feel about the way we showed up and felt during and after the birth that matters … I have … been with women planning for medicalized births who go through them in such beautiful, graceful ways that the fact that interventions were involved was dwarfed by the love, connection, awe and power present in the room. I have come to understand that any birth can be conscious, no matter where it happens and how much it stuck with the mamma’s original plan.
She also notes that she prefers the term “Birth Preferences” to “Birth Plan.” So here it is: My preference is to avoid unnecessary interventions, but above all, I’m planning to have a conscious birth.