Tuesday, March 2, 2010

Choosing Home Birth

July 2009

The pregnancy test is positive. Thoroughly surprised, but also ecstatic, I am elated to find out that I am now expecting our 5th child. We have a 14 year old son, 11, 9 & 5 year old daughters. 2009 has been a rough year so far, my husband laid off by two different companies and considered unemployed for three months of the year... we currently have insurance, but are well aware that another layoff is probably imminent.

2009 began with the sale of our home for the purpose of not loosing it and downsizing. We were blessed to sell it for full market value. July finds our family renting a home across town. This is when we find out! The miracle of birth is exciting, and for a while all the other worries fade. Our efforts focus on finding another home before the school year begins.

We find a home that works and move back over near our old neighborhood. Life returns to normal for a few short weeks as school and friends, piano and soccer begin their daily revolutions. This is when the third job layoff comes. Now we know we will have no insurance in just one short month.
The only Certified Nurse Midwives in town practice with the Pocatello Women's Clinic. A midwife has delivered each of my daughters so far, and I would never switch back to a doctor. I love the support the midwives give by staying with me throughout the labor, helping me breath, coaching and supporting the natural childbirth process. But never yet had I entertained or even thought about having a home birth. To be honest, I thought it must be a dangerous thing - not to have all the emergency options available at your fingertips.
After my first appointment I met with the financial secretary and she went over the prices with me for the average delivery at Portneuf Medical Center and Women's Center Pregnancy fees. $10,000??? When did the prices go up so high??? I could swear my last delivery was no more than 1/2 of that. With no insurance, and unable to qualify for medicaid this was certainly a sobering situation.
At this point I started to wonder - what else can I do? What could be cheaper? I had heard of a friend who had just had a home birth a short while before. Of course, she was a certified Doula, and an amazing woman, but I still wanted to talk with her... I wanted to find out how she was so brave as to have her baby at home.

Bumping into her and hearing her story was wonderful. Inspiring wonder, awe and even the thoughts of - could I do that? I found out that her midwife at home had everything necessary to monitor mother and baby, that a 'birth kit' was supplied in her home in case things moved faster than the midwife could get there, and that the midwife was trained in Newborn Resuscitation and had oxygen and all the medical necessities that may be needed for everything short of a c-section - for which, course, transport to the hospital would be the course of action. The price tag for such services? Right around $4,000. With no insurance that certainly sounded better than $10,000. But would it, could it really be safe. I knew that the reaction of friends and family - those who would say exactly what they thought, not sparing my feelings - would be shock, concern and disbelief. Afterall, our is a society of advanced allopathic medicine - how could one trust anything different?

Of course, I absolutely trust the labor process as natural and nearly perfect; in my mind and experiences, any intervention carries many more risks than benefits. But... what if... And as I listened to my own thoughts, I realized, the only reasons I can come up with not to have a home birth is fear. A fear cycle. I don't want to be a slave to my fears! So I began to meditate and pray. What would really be best for me? What would really be best for my baby.

At my next midwife appointment at the hospital, I mentioned my concern about the H1N1 virus and how no one was being allowed to attend the birth except for my husband. (I really wanted my other children to be able to be present right after the moment of birth - or before if they desired). My midwife said she also wished that she could eventually work it out with her practice so that she could do home births, but that the Doctors in the practice were currently opposed to the idea. And I realized... why would I wanted to have my new baby in a place where the most concerning illnesses are being treated? Why would I want to expose my baby to that - just so that I could be in a hospital?

Now I found that I had more legitimate concerns and questions that needed to be answered. I called and visited with my friend again, as well as contacting a midwifery practice that ran a birth center as well as did home births. Each of these women had something in common; complete trust in the birth process with no need to interfere or control it. In theory, I could agree, but somewhere deep in my mind I still struggled; maybe I'm different, maybe it won't go smoothly for me, maybe I can only be safe at the hospital. But the more I learned, the more experiences of home midwifery that they related, the smaller and smaller my concerns became.

I made the commitment to home birth and switched midwifery practices mid pregnancy. I knew that these midwives knew what they were doing; and that they would not do anything that would compromise me or my baby in anyway. They would err on the side of caution; they would support us all the way, even as a friend at the hospital if it came to that. But what I loved was their very small rate of hospital transfers - less than 16 out of more than 400 births - averaging a 5% or less need to transfer!

That night I dreamed a very strange dream in deed. Myself and my husband and children were on a cruise (I've always wanted to do that) and having the time of our lives. Everything was just as I had ever hoped for such a grand adventure... And as I woke up from the dream I realized that it represented my choice for home birth and how excited I was for it - and what a grand adventure it would be - and I laughed about that to myself all day long. My subconscious mind was likening a home birth to a family vacation cruise adventure!

Well, at this point, my major concern was would my new midwives be able to make it to my home in time??? Their practice was no less than 1 hour and 15 minutes from my home. Would I know that I was really in labor early enough to give them the time to arrive and help me? So, I called my friend again to see if she could be my doula. She was possibly moving and wanted me to see if I could find someone else - but if she was available she would come. This comforted me as she is only 5 minutes from my house.

Realization slowly dawned on me over time that if my labor was so fast as to be unable to give the midwives enough time to get them here before the birth, then everything would be going very smoothly with no complicatoins. Complications would slow the whole process down and they would be there in plenty of time.

So now we wait. It is March 9th. My 20 week ultrasound put me due on March 15th, my period date says March 17th, and conception date is March 20th. No matter what I am done to the wire. My biggest concern right now is of a very big stomach. At my 38 week appointment I measured 46 cm (usually the cm measurement equals your weeks of pregnancy). I have been measuring about 5cm larger than my weeks since week 28. I had my midwife really feel the baby to see if she could tell how big she is. My midwife feels the baby is currently between 8 - 8 1/2 pounds, and also that I have lots of amniotic fluid, which is why my measurement is so large.

Besides being slightly concerned about my ability to deliver a very large baby, I have few other worries. Of course, I hope all the stars will line up correctly so that my husband and children can be here with me when the time comes... and I'll blog the whole birth story as soon as possible under the title 'My home Birth.'