Do Women Matter in Childbirth?

BlogHer Original Post

The news recently has been full of stories about home birth -- they're on the rise in the United States (up 29 percent since 2004), even though rates remain comparatively tiny. A home birth advocate in Australia died from unknown causes after giving birth at home, and more recently, a woman was arrested in Indiana for practicing midwifery.

I wrote a piece for Slate about it, hoping to clarify that not all home births are created equal and one with an experienced, well-trained certified nurse midwife (CNM) with a hospital-based, backup OB and hospital access is the gold standard if home birth is your choice.

I also argued that many women in the U.S. don't have this choice or the choice of a hospital that offers an environment conducive to health and bonding between mother and child, which is, in fact, the case. A blogger over at Babble summed up this core argument better than I did in her post about my piece:

Even if home birth was a real option for a segment of the population in the US, we still need to work on improving hospital care and outcomes! Fewer women would be opting out of hospital births if they didn’t feel their births would be overly medically managed to the point of introducing new risks from medications and surgery. Hospitals have much to offer in terms of emergency care, and a lot less to offer a low-risk mom who would prefer a birth with few interventions.

My Slate piece opened with a paragraph about my own experiences with the births of our first two children. In my original draft, I'd had that information at about paragraph three and written differently, but for reasons of narrative and word count limitations, it was moved to the top. It opens with a mention of fluorescent lights -- not the way I'd originally described it, which was simply, "fluorescent lit" -- and continues with a very brief description of that birth and the sequelae. The birth was no picnic -- what birth is? -- and my husband and I both were not thrilled with aspects like hospital visitors peering in through the open door as I laid there, spread eagled in stirrups, pushing and covered with the effluvia related to birth. But the aftermath was what left us so upset that to this day, we just don't talk about it with each other.


Photo by dchasteen. (Flickr)

I described this aftermath briefly in the article -- it consisted of the hospital's forcing our son to have 12 blood draws for glucose testing for no medically indicated reason (he was full-term, perfect Apgars, feeding well, all readings were normal, our pediatrician was appalled) against our will and without our informed consent.

They also aggressively threatened us with separation from our healthy son and with dismissal from the hospital while they retained our son, unless we took him against medical advice. I was probably a hormonal mess -- I had just given birth after three days of sleepless prodrome, we were first-time parents -- but hearing the click as they ripped into his heel 12 times and listening to him shriek with pain every three hours (during which we anticipated each draw with growing dread) made me feel like I was feeling what he did, and that empathy between us has persisted to this day. When we finally did leave the hospital, within a day or two, I was fighting a raging hospital-acquired infection that required some powerful drugs to treat and interfered with my ability to breastfeed our boy.

It was these effects on my son -- not me -- that led us to pursue home birth for our second child, born in 2002. I was terrified of the prospect of a home birth, not because of safety issues -- the literature I could find at that time indicated good safety profiles for CNM-attended births with an OB backup and hospital access nearby, which is what we had -- I was terrified about the pain, about whether I could do it. But I forced myself to do it because I did not want our second son to go through what had happened to our first without medical indication.

It wasn't because I had some nutty idea about a beautiful or lovely or fluffy birth experience. Birth isn't fluffy. It's hard as hell, and yes, emergencies can be sudden and fatal. We were fully aware of that. A hospital was blocks away. Had it not been, we'd've elected simply to be in a hospital because safety would have tipped the scale that way.

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