Thursday, March 01, 2007

Be It Ever So Humble

Because I was way too well behaved as a teenager - i.e. converting to Mormonism at 16 and thereby eschewing everything from sex to drugs to frappucinos - I'm still looking for ways to retroactively irritate my mother. And so far, I think the best one I've come up with is planning a homebirth.

I really liked and supported the idea of homebirth during my first pregnancy, but after the cavalcade of medical interventions we'd endured just to get pregnant, on top of the regular newbie fear of the unknown, I didn't pursue it as a realistic option. Besides, we had a natural birth-supportive OB, a small, cooperative hospital and a well trained doula on our side. Thankfully, the labor and delivery all went as well as I could have hoped, nearly duplicating the birth center experience I craved but couldn't get in Memphis. Since we didn't have family in town, we actually liked spending those first few days in the bubble of the hospital, where the sheets were always clean and the meals (so to speak) were regular. The nursing staff was small, friendly, and very knowledgeable on breastfeeding. They admired my labor and delivery, considering that the epidural rate in Memphis is 99% and the c-section rate is above the national average. One nurse even said, "It's so nice to see that women can still have babies!" My doctor supported my effort as well, telling me after my long, strenuous last stage of labor that having an epidural would have guaranteed an instrument (forceps or vacuum) delivery, if not a c-section.

But three years later, things have changed. Our insurance moved to a new company that no longer covers my former physician. The hospital where I delivered has closed its maternity center because it couldn't compete with the gigantic new women's hospital. And because of my job, I spend every single day hearing about women's birth experiences all over this city. I do hear some positive stories, tales from moms who have found that perfect match of doctor, hospital and nursing staff that is so crucial to having a natural birth in an unnatural setting. But for the most part, what I hear are sad and sometimes horrible stories of caregivers and facilities that simply refuse to support a laboring mother in her most basic needs. Sometimes I even know the story before they start telling it; there's one particular hospital that has yet to send me a customer without a c-section scar.

On the flip side of these stories, however, were the mothers who had delivered their babies at home. With these moms, their experiences were so overwhelmingly positive and satisfying that it was hard to ignore the contrast. Even with the limited midwife options available in this town, these women had found skilled, conscientious caregivers who guided them through their births rather than dictating what their bodies should do. The idea of homebirth, which once seemed so exotic and unapproachable, began to grow more and more appealing.

So when I did get pregnant again, and all the options were in front of me, I found myself leaning very strongly toward delivering at home. Although I did have a generally good experience with Miss M's birth, there were still several significant parts that I did not at all enjoy. The aggressive coaching, the confinement to bed while I was pushing (for all three hours), the seeming OB impatience leading to a pretty impressive level of tearing. All things I'd like to avoid the next time. Knowing that I'd have an even smaller chance of having the birth I wanted in a new hospital and with a new doctor was discouraging as well. Not that I made the decision by default - the more research I did, the more I felt that homebirth was the best option for me, even if I could have had my almost-perfect first birth all over again. The only thing on the negative side of the scales was not knowing how supported I'd be by the two people whose feelings had the most bearing on the decision: The Admiral and Mom.

When we first started seeing the midwives, it was on more of a consultation basis. I tried very hard to keep my mind open and not make The Admiral feel that I was just trying to push him toward agreeing with me (which, I fully admit, is my general tactic on all matters maternity). I understood his fears and concerns, and appreciated that they were focused on my health and the baby's, but I also knew he hadn't looked at the numbers as intensely as I had. Or rather, that he was looking at different numbers. He was focused on the tiny percentage of really, really bad things that happen during labor, whereas I was thinking more of the dozens of common, aggravating interventions that occur during even an ideal hospital birth. He didn't want me to bleed out in our bedroom. I didn't want to have someone tell me I had to eat ice chips when I wanted a grilled cheese sandwich. His scenario was much more serious, but mine was a lot more likely.

[To Be Continued ...]


Stephanie said...

It's fair to say I tend to think like the Admiral. I'm such a scaredy-cat! (Something I definitely inherited/learned from my mother.)

Cathy said...

I got to your blog through Stephanie. I am having similar feelings about the birth of my not yet conceived second child. While my first was early, causing the medical interventions to more than triple, I'm considering a more natural option for the next birth. With the first, I was too much of a chicken to move away from the norm. I hope you have a wonderful home birth experience!