Sunday, November 16, 2008

Where, oh where, will the baby be born?

Beware. This one might be a tough one for people. We've gotten mixed reactions from folks so far, but the gist of it is this... we are going to birth the baby in our own home with a midwife who does this kind of thing.

A lot of people's first reactions focus around the mess that could be created (and when I say "a lot of people" I really mean me). The picture I have in my head is a screaming newborn and some sort of "gunk" covering the ceiling and the walls. Kind of like the end of Ghostbusters except instead of marshmallow, I'm covered in "fluid." I get past that pretty quick though and so should you. The second most popular concern is around safety. When we first started this investigation I kept saying to myself "Has there ever been a baby that died at home because it wasn't at a hospital? Yes. Has there ever been a baby that died at the hospital that would have been saved if it were at home? No." It seemed like a no-brainer to me at the time. Why not have the baby at the place where it has the highest chance of living? The problem with these questions is that they're actually the wrong questions.

So here's where it started: The thought has been floating around in our heads for a while, but the movie "The Business of Being Born" really pushed us over the edge. I recommend watching the movie and then checking out some of the debate on the Internet. I liked the movie. I did, but probably not for the same reason other people like it. There are tons of big fans out there that really identify with the movie's criticism of the process of birthing a baby in a hospital. The reason there are so many more c-sections now than there were 20 years ago have more to do with hospitals and doctors' procedures and preferences than changes in women's bodies. It stems from the belief that women are idiots about their own bodies and experiences and they need doctors to come along and rescue them with "science." The movie does use some research and statistics to make some arguments, but this really is where it falls short as well. So much of the movie is about personal preference. People in the movie state what their preference is as "fact" or their negative experience with a doctor as "the norm." I'm just not black and white enough for grand sweeping statements. I'm fine with anecdotal information to support an argument, but in the end what you think is "the best," is really "the best for you." So check the movie out and if you think we're nuts for doing this, maybe the movie will begin the process of opening you up to alternatives.

In reality though, here's what we've learned so far... For most pregnancies a home birth is fine. Having a doctor deliver a baby is overkill.

Also, for most of the pregnancies where you do need a doctor because things are/could be hairy, you know that in advance. You know if your having multiples, you generally know if the baby hasn't turned the right way, and you know if the mom is high risk.

Then there's the stuff that you don't know about. The surprises. Obviously this sucks, but even with most of the surprises you have plenty of time to get to a hospital. We live a maximum of 10 minutes from theemergency room.

So by now you may be saying, "I get that a hospital is over kill in most cases, but why take a chance at all?"

Good question. People have tried very hard to find a research study that officially says hospitals are safer and they have yet to prove anything like that.

First off, and this may come as a huge shock to people... our medical system is messed up. We don't have our birthing stuff figured out. We're in 40-something place as far as infant mortality. That's below Cuba and Taiwan and right above Croatia and Belarus. Not really the stellar credentials you'd expect from a hospital system that shames you for not using their services.

Women having babies in hospitals these days are having a ton of C-sections. Don't even count the "designer births" where people schedule the exact day they are having their baby and then cut it out. We're just talking your average person in a hospital. The World Health Organization recommends that Caesarean section rates should never be above 15% in a developed country. The US was at 30.2% in 2005. Now there IS plenty of research showing negative impacts of C-sections for mother (increased risk of death, problems with second birth, and infection) and baby (increased risk of diabetes, asthma, and problems breast feeding).

Most people don't want a C-section. It's risky, its major surgery, but still rates continue to go up. It doesn't make any sense. There is no one reason that is going to explain this for us. Some people seem to think that they have it all figured out. That the evil doctors are lazy and want to administer drugs in order to control the timing of the birth, then things get messed up and SHAZAMM they have to do a c-section. For me its just not that simple. (There is no agreement in the research as to whether or not an epidural increases the likelihood of a c-section.) It's not just one answer. But just because it can't account completely for a rise in c-sections, doesn't mean its not true. There are patterns and systems at work within a hospital that support the use of drugs and c-sections.

Okay, last point here. And this is where I really get on board. Birthing a baby anywhere can be painful, intense, and really scary. If you have to do something painful, intense, and scary, you'd probably want to do it in a place that feels the safest to you. For many people this is a hospital. For many pregnant women, they can start to feel safe and try to relax once they get to the hospital. No judgement here. Hospitals are great places for some people.

So my question for you is this: Have any of you ever seen Jen Johnson in a hospital? There are probably a few of you who have seen her near a doctor or getting a shot. If you have then you know that it isn't a pretty sight. I have seen Jen in a hospital and I remember one time when Jen had to have a needle in her arm for a while and she called all of the nurses "assholes." A hospital would be the perfect place for a Jen Johnson nightmare. Fear and adrenaline slow down the birthing process making the situation more dangerous. So we pretty much avoid all hospitals if we can.

I'm not going to make any grand sweeping conclusions about what other people should do, but I know this, Jen feels more comfortable going with a home birth. She's smart and she knows her body and her self. So a home birth is the right choice for this family.


Chris said...

Thanks for sharing...such a good blog. The part about Jen getting to choose where she has the baby almost made me cry...I know, I know, it's the crazy feminist in me, but how cool is it to live in a world where she can make that choice and her (male) partner is supportive and advocates for it?!?!?

MarcMaxson said...

The only thing more stressful than Jen in the hospital is Chris in the Airport. I heard Jen once got a shot WITHOUT passing out!

Katherine H. said...

Go, Jen! I'd call them assholes, too.

The Peterson Family said...

First of Congratulations, Mike told me awhile ago and then told me about your blog. I had a home birth and it was the most wonderful thing, I would recommend it for anyone. I am so happy for you guys. I have just started reading your blog from the beginning so I have not gotten far. I am so glad that you have started this blog.
~Mike's friend Jen