Giving birth at home

in #parenting5 years ago (edited)

My wife has a pretty strong opinion on this: if there are no expected complications, it's much better to give birth at home rather in a hospital setting. She probably has a point, and she has experienced both by now. Let me share my point of view and experiences.

Traditions vs science

I'm quite obsessed with it: medicine should be based on sound science. When seeking the doctor, going to a hospital or being prescribed some medicine, I expect that the treatment and service I get is scientifically proved to be good for me. With this perspective, I was absolutely shocked first time my wife suggested doing it at home. Forsaking scientifically proved sound treatment? You must surely be kidding!

Digging a bit deeper, I found that the practices for handling birth in the hospitals are not so much based on scientific research - it's mostly based on traditions. Well, perhaps knowledge based on "traditions" are better than no knowledge at all. Case in point: your mother probably told you to dress well in the cold weather, or you'll catch a cold. Last time I checked there was only two small studies attempting to test this hypothesis, and they concluded differently - hence, it's not scientifically proved there is a correlation between freezing one day and becoming ill the next day. Still, investigate and you'll find people across so many different cultures, all have been told by their mothers to dress well in cold weather - maybe there is a nugget of truth in it?

Kirill Vikentevich Lemokh - public domain, via Wikimedia Commons

Investigating further, it appears like the traditions are rather new - one doesn't have to go much back in history to find that nearly every birth would happen at home. I also found it quite likely that the primary purpose of the birthing chair is to give the birth doctor better working conditions, not to make it more comfortable for the mother to give birth.

Birthing chair.  Wellcome Library, London.  CC-BY-4.0 via Wikimedia Commons

One argument put forth is that the child mortality in the "civilized" world has dropped from "very significant" to "almost insignificant" during the last centuries. Can hospital birth be part of the reason? I actually doubt so. As a point-in-case, read up on Ignaz Semmelwise on wikipedia - he discovered that the death rates was much higher (both for the newborn and mother) on a clinic where medical students went directly from autopsy to childbirth without washing their hands. Semmelwise found empirical evidence that if the washing hands drastically reduced the death rate, and he also found that using chlorine while washing hands was efficient. Semmelwise was laughed at.

Some studies has been done in Norway on home births (Ellen Blix) - according to the studies neither mother nor child is in any higher risk of death or serious injury when doing home birth than hospital birth. In said studies, there were no expected complications in the birth cases studied, the home-births were assisted with a professional midwife, and the births happened in "civilized" areas where it was trivial to call for an ambulance if the situation would escalate.

Interlude - a funny YouTube film

I would very much recommend to spend the time watching the youtube film The Performance - Sex like Birth. (6:37+ credits). It's hilarious, provocative and yet relays a pretty good point.

For those of you that really hates video references, here is the summary:

Oxytocin is the love hormone and is produced during sex, labour and birth. It is not produced in stressful conditions.
What would happen if sex was interfered with as birth is interfered with?

(some 4 minutes with four persons messing around - one couple trying to conceive and one doctor and nurse doing whatever they can to give professional advises - well, really just disturbing the couple as much as they can. What outcome would you expect? Of course, the couple cannot perform)

(nurse) Its' OK. You tried your best
(doctor) Now we'll take care of it. It's our specialization
(nurse) What will I write in the file?
(doctor) Write "failure to progress"

WHO recommend that women are free to choose their position during labour and birth.
Unfortunately most women are required to lie down on a hospital bed
Episiotomies are only carried out in this position
70% of women end up with their vaginas cut
Eating and drinking are not allowed for the full duration of labour and birth. There is no medical reason for this.
In most hospitals women receive synthetic oxytocin during labour to speed it up.
Fetal cardiac monitoring and IV fluids are often used for the full duration of labour therefore making it almost impossible to walk and move freely.
Unfortunately, in most hospitals these interventions are performed without informing and asking for consent.
In Italy 4 out of 10 women end up with a c-section. "Failure to progress" is the most frequent reason given by medical staff

(8 month later, woman visibly pregnant)
(man) We have to thank the doctor. Without their help, it couldn't have happened.
(woman) They were great.

Fathers perspective

I must admit it - I'd rather stay at the pub during the birth moment and receive the news there than being a witness to the birth - and I believe quite many men have similar preferences, though maybe not all of them would admit it to their wife.

This seems like a place I rather would like to be.  By calflier001, CC-BY-SA 2.0, via Wikimedia Commons

I always found it a bit obsessive to focus so much on the birth moment. Infancy and childhood is a long road, it's scientifically proven that the fetus already starts learning about it's surroundings long before birth - the birth moment is nothing but some few hours of a long life. Perhaps I'm a bit old-fashioned, but I think the birth and infancy is a mothers thing - there is something biological to it, for one thing we're not that good at breastfeeding, but I believe it's more than that. The mother and infant has a very special bond, while the fatherhood really starts blossoming when the child gets big enough to play with a ball ...

Still, birth is a quite so critical moment - perhaps one shouldn't underestimate it.

Personal experience

We've been through pregnancy five times now. We're living in Norway, but all five times we've been together with her parents in St.Petersburg, Russia. Giving birth in Russia has been important for us, as it's the only way to achieve dual citizenship. During our first birth both of us thought it would be better for her to give birth in a hospital in Russia than in Norway.

First birth

The first birth was awesome. It didn't look that bad ... in the end it almost seemed like the birth had taken a harder toll on me than my wife (I had to leave my car by the birth clinic, my father-in-law had to drive me back for the night).

We could easily afford to pay for a "luxury birth" (which is required if the father wants to join the birth - or, in my case, it was more like if the mother would insists that the father should join the birth). We even got all our costs covered by the Norwegian state, and probably even saved some taxpayers money anyway, as it's much cheaper with hospital stays in Russia.

In Norway very pregnant people are often refused in the hospital (like "oh, come on, you're not giving birth now ... please go home again, and come back when we're done with our lunch break"). Not so in Russia. The pregnant women are supposed to meet up in the hospital long before the due date, to be sure they make the birth in hospital settings. It sort of makes sense, in that very moment one is to give birth, one of the worst thing to do is probably to be stressed out stuck in traffic jams.

We were visiting a lot of birth clinics the days before the birth to see which one we'd prefer to give birth in. Well, in the end we didn't quite chose the clinic ourselves - our son did, he decided to get born just as we were supposed to be getting a guided tour in one of the best birth clinics in the city ...

All in all, I had a very good impression of the hospital. I was really shocked when my wife years later, during her next pregnancy told me how horrible the hospital experience had been for her and that she'd rather do it at home ...

Second and third pregnancy

Our second child came with the feet first. My wife really didn't want to give birth in the hospital, but it was so painful she had to call for the ambulance anyway. This birth also came quite a bit earlier than expected (I was going for a business visit in Tallinn, came there Sunday evening, returned to St.Petersburg Monday morning without meeting anyone in Tallinn. I was so disoriented I first banged my head into a glass wall, right afterwards I managed to drive the very wrong direction out of Tallinn. I paid for skipping the border queue in Narva, but got stuck on the bridge between Narva and Ivangorod for more than an hour as the Russian border guards were having their lunch break. When I finally came to the birth clinic - the baby was dead. Remember what I wrote about bonding earlier; my wife already had made a very special bond, and she was really struck with sorrow. It was much easier for me to carry the loss.

Third pregnancy - miscarriage.

Second son

Our second son was born quite regularly in an ordinary birth clinic, quite much due to the previous two incidents (we got quite much extra follow-up and extra care both in Norway and in Russia). Maybe also a bit because I didn't really want a home birth. I think my wife "moved in" the day before the birth - no hurry, we took the bus to the birth clinic. We spent some hours together there before the birth ... my wife told me "now it's happening", she wanted me to be there and she had found a "loophole" in the rules that would allow me to witness the birth without any extra payment. The doctor claimed that she wouldn't give birth that day, so I left the building, took the bus to the nearest metro station ... I think before I got there my wife called me: "come back, now it's really happening!". I took the bus back to the hospital, was denied entrance by the security in the ground floor and had to sit down and wait there for half the night ... all until my wife called me: "everything went fine. Please go home and relax".

Our daughter - the perfect birth

We were staying with her parents, eating supper together as my wife whispered to me: "tonight it's going to happen".

Some hours later, in her childhood bedroom, our daughter was born. It wasn't pretty, I was pretty stressed out to be honest, I didn't quite know what to do. Despite my wife telling for several years that she'd like to give birth at home, I was totally unprepared for any midwife service - shame on me. I wasn't particularly useful at all, my wife did it all herself, she did a great job. No screaming and agony, she received the baby with her own hands, and went into breastfeeding mode. Her parents (sleeping in the neighbour room) woke up only some hours later, met the newborn, cursed a bit on their silly daughter being too stubborn to go to the birth clinic, ate breakfast and went to work...

I would totally have done it again, and I would totally have tried to prepare myself a bit more for it.

Well, of course - I must admit, the fact that the birth went so well may as well have been because of experience rather than the setting.

Aftermath

Well, we did get some problems with the beurocrazy (sic ... misspelling intended). Home birth is pretty abnormal in Russia, one is not supposed to do that kind of things. It's even illegal to do midwife assistance to people doing a home birth. My wife called her doctor during the daytime, and the doctor was clueless on what to do with this situation - she could only advice to call for an ambulance. So she did ... the ambulance came, I think they cursed a bit on being called for in such a non-emergency situation (or maybe they cursed because six hours had passed from the "emergency" until they were called for), my wife and the baby was taken to the local birth clinic for inspection and she got her papers.

The Norwegian state gives some financial aid (like in "thank you for not wasting our taxpayers money on giving birth in the hospital - here, have some of the money we just saved") to people giving birth at home, but the form has to be signed by the midwife, they didn't accept me being the witness, so we never got that support.

Conclusion

Our children are 12, 5 and 2 years old as of today, only the last one was born at home. They are all doing fine.

I have become quite convinced that in uncomplicated cases it is better to give birth at home than in a hospital.

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Studies have shown that when animals are put into an unfamiliar, chaotic environment, their labor will not progress. That's why they always go somewhere quiet and secluded by themselves to give birth. I don't think humans are any different so it doesn't make sense to give birth in a hospital. All the unnecessary interventions due to doctors' greed and wanting to keep the assembly line moving increase the chances of complications too.

Right. I think the youtube-video I've linked up to sums up that perspective pretty well and in a pretty convincing manner, I didn't want to repeat the arguments from there. (edit: I've changed the post a bit, inlined the youtube video and written up a summary for those that really hate video references).

Sometimes the shit really hits the fan - there is an emergency, a caesarean is needed, and it would have been fatal if one would have had to call for an ambulance and had some 20+ minutes delay due to this. After such an experience the new parents are usually pretty happy that they chose to do their birth in a hospital and not at home. Then again, maybe it would have been no need for a ceasarean if the birth had happened at home? This perspective is also touched on in the end of the said YouTube video (06:20)