Home Birth vs Hospital Birth

When I was writing about the birth of my third child, Dylan, I became so thankful that I had been at home instead of in the hospital.  I imagine if I had gone into the hospital after having the stomach flu, they would have felt it necessary to intervene in many ways.  They wouldn't have let me eat or drink - that's standard procedure - I might have been able to suck on ice cubes.  (They're concerned if they have to do a C-section that I might vomit and choke in my own vomit, so they keep stomachs empty.)  At home I was able to drink when I was thirsty and I ate a little bit of chicken noodle soup.  I think they might have given me fluids so I wouldn't be so dehydrated.  So I would have been tied to the bed with IV fluids as well as with the fetal monitor.  Nancy used a low-tech "horn" she put on my belly to listen to the heartbeat.  She also had a stethoscope. 

In the hospital I probably wouldn't have been able to walk around or belly dance or sit on the toilet to labor.  I might have had to use a bedpan for the diarrhea.  I would have been perceived as a patient, not a woman doing something quite natural (albeit in a weakened state from the stomach flu).  Nancy knew I'd been sick, but to her I was a powerful woman giving birth - of course that was the normal thing to do.  The flu was tertiary, if that. 

I know hospitals have made progress since 1992.  Doulas attend many births to help women be able to follow their birth plans.  They run interference with the powers-that-be when necessary/possible.  I know that must make a difference.

But still the rate of cesarean sections is 33%.  In 1992 it was a whopping 23%, and that felt awful.  It has increase almost 50% by then.  What that says to me is that birth is becoming ever more medicalized.  It is more convenient to have a C-section - it can be planned.  The time frame is limited.  Everything can be sterile and mostly controlled.  Those are positives.

To me, though, C-sections disempower the woman and the birth process.  Women who have them once usually are told they have to have them again.  Their recovery time is long and arduous, making it harder for them to bond with their babies because of their limited mobility and sore abdomens.  The doctor is in control.  The woman can't see the birth process.  She is anaethesized and can't feel what is going on.

For me, realizing I could cope with the intense feelings of labor was empowering as heck!  Things shifted in me after I gave birth, especially after Laura's birth at home.  I felt like the most powerful woman on Earth!  I could do anything if I could give birth to a 9 lb baby at home with no drugs!  My body became my ally rather than just something to carry  me from place to place.  It was very, very powerful.

I ache for women whose doctors tell them they have to have a C-section at such-and-such a time on such-and-such a day, women who don't know the power they have in their bodies to bring another being into existence without interference. 

I hope that doctors become more acculturated towards the naturalness of birth and become more able to support women in making empowering choices for themselves.  I believe it could shift our society towards a gentler better world.

Birth #3: at home 2

The joys of having children were sufficiently great for us to decide to have a third child when Laura was about 2 1/2.  Once I found out I was pregnant again, I called up Nancy, the midwife, to make an appointment to see her.  Having the time with her was one of the huge plusses of being pregnant.  She was such a great person to spend time with.  I always felt so good after our appointments.

The pregnancy progressed well with few issues except for exhaustion.  I was working a lot of hours tutoring as well as taking care of Andrew and Laura, so by the time I got home from work, I was usually quite tired.  I didn't have the self awareness or confidence to take the time to rest each day.  Instead I internalized my husband's admonitions to just get over it and get on with what I needed to do.  So I dragged myself into the kitchen to cook a meal, took care of the kids, and otherwise functioned as best I could.  It wasn't the best time in my marriage because my husband and I couldn't seem to find empathy for each other.  I was exhausted and couldn't allow myself to rest despite his judgments.  I thought I should be able to work and keep a clean house and be a perfect mother and a great wife, all while still nursing my daughter and growing another baby.  If I had it to do over again, I hope I would be clearer about what my needs were and do what I needed to do to take care of myself.  It was a hard time.  I remember telling Nancy I felt like I wasn't focused on this baby the way I had been on the other two because I was so overwhelmed.  She assured me that he/she was growing well and flourishing and that when he/she was born, he/she would get all the love and attention he/she needed then.  In the meantime, I could trust that he/she was well taken care of.  What a gift that was to be able to let go of my expectations that I be a perfect mother to the unborn baby too. 

Of course whenever I had a quiet moment, especially before going to sleep, I would take time to commune with the baby's spirit, but those moments weren't as frequent as they had been with the other two.  Still, time progressed, and I prepared for labor.

My dear friends in my women's group held a Blessing Way for me.  What that is is a ceremony we've crafted from bits and pieces of ritual from here and there.  It's different each time, but the primary components include sharing and celebrating the baby's impending arrival.  One of the women made a wreath of flowers for my hair and another washed my feet with herbs then rubbed them with blue cornmeal to signify preparation for walking the sacred path of childbirth.  We had a birthday cake (though since I wasn't eating sugar at the time, it was a beautiful belly-shaped loaf of bread instead!).  Each woman had a candle which she lit and put into the bread as she said a wish for the baby, much like the fairy godmothers in Sleeping Beauty (but all these wishes were good ones!).  They wrote the wishes down on a card so they'd be preserved for posterity.  Then came the talking, a time for sharing the wisdom they had accumulated in their experiences.  We shared about other births, about our hopes and fears, our good wishes for this child's life.  One of my friends was an accomplished belly dancer.  She explained that belly dancing used to be something women did among themselves, especially during childbirth because the gyrations were perfect for quelling the pain of childbirth and helping the body accomodate the contractions more easefully.  She then danced for us so I could see how it looked. 

All during the pregnancy, I had been reading affirmations about giving birth.  A friend had given me a book she had made with them in it.  Examples:  I birth my baby like billions of women before me.  The pain is my power.  All is well.  This baby knows the exact right time to be birthed.  I have since made many of these books to pass on to other women for their pregnancies.  Mine was so important and helpful to me.

On March 24, 1992, two friends of ours who had been living in Germany came to visit us for a couple of days.  They had had the stomach flu but said they were over it so kept to their schedule and came on for a visit.  It was lovely to see them as they're terrific, interesting people with whom I love to talk and visit.  Unfortunately, though, I caught their bug.  The night of the 25th, my husband was called to work in the middle of the night.  A few hours later I woke up with a very queasy stomach and ended up needing to vomit.  (I can feel sympathetic nausea as I write this all these years later!)  I got up and leaned over the toilet.  It was actually very difficult to do, given the fact that my belly was as large as it could get.  It was a big hindrance in that situation.  Martin, one of our guests, was so kind.  He came upstairs and helped me clean up and get back to bed.  I fell back into a fitful sleep.  But was back up several more times.  My husband still wasn't home, though it was 3 or 4.  I guess he eventually came home but left for work again at 6:30.  Though our friends were leaving at 10, I tried to stay in bed a little bit longer to recover a bit from being so sick.  At 9:30, I dragged myself downstairs to say goodbye.  Our au pair had gotten the other two kids up and was keeping them occupied.  It was clear to her how I was feeling.  After our friends left, it quickly became apparent to me that I was having contractions.  At least I thought that was what it was.  I prayed it wasn't more nausea.  I called Nancy who suggested I take a bath.  If it was labor, that would either slow things down or speed them up.  Rita, our au pair, drew me a bath.  It definitely sped things up.  I called my husband and told him what was happening.  He asked if I wanted him to come home.  I told him it might be a good idea if he wanted to be there for the birth.  He got home shortly afterwards and found me still in the tub.  Mom came to get Rita and Andrew and Laura since things were starting to happen quickly.  My husband and I talked about a possible name for the baby.  We hadn't been able to decide before.  We decided on Dylan (as in the poet, Dylan Thomas, and the musician Bob Dylan) for a first name if he was a boy.  The middle name was harder.  Because we're both such intellectuals, we wanted something cool for a middle name, so we came up with Raphael, after the painter.  If the baby were a girl, her name would be Sophie Elizabeth, simply because we liked how it sounded.

I called Nancy to let her know how things were going.  She was at another birth and wasn't sure how quickly she'd be able to be there, so she suggested I call my friend Mary from my women's group who was studying to be a midwife and who had attended many births before.  Mary came right over.  In the meantime, I threw up a couple more times, and now diarrhea was kicking in.  Try that on for size - labor pains, intestinal pains, needing to throw up, and needing to have diarrhea.  I didn't know which end should be where.  I was intensely miserable.  And worried about trying to give birth in such a weakened state.  I was feeling somewhat panicked.

When Mary got there she suggested I lie down on the sofa.  She talked me through a visualization and meditation which really calmed me down and helped me gather my resources.  I decided to let that gentle repose be a perfect substitute for a full night's sleep.  The contractions continued, but more gently, and I was able to sleep for almost an hour.  Nancy arrived around that time.  She examined me and asked me if I wanted to keep things slow or let them get going.  I gathered myself and said, "Let's go.  I'm ready."  I got up and walked around the den then spent some time on the toilet again - apparently that's a really good place for me to labor!  Transition began then.  I went into the den where I was planning to give birth.  Standing, I leaned on Nancy's shoulders while my husband held my belly up from behind.  I gyrated my hips in a belly dance circle.  The contraction came on, I moved my hips around with it, it dissapated like magic.  The movements truly ameloriated the pain to the point where it was manageable.  My affirmation was "This is the most intense feeling I have ever experienced.  It is opening my cervix so I can birth my baby."  Rather than focus on the pain, per se, I focused on the effect it was having, making it more bearable and positive. 

I wanted to squat and give birth as I had with Laura, but I simply wasn't strong enough because of the stomach flu I'd been dealing with, so I sat on a mattress on the floor and leaned against our sturdy mustard-colored arm chair.  My husband was behind me, Nancy in front of me, Mary on the sofa next to me taking pictures.  I felt exhausted and weak but I knew I had the power to birth my baby.  The pushing contractions came over me.  I let them wash over me and through me.  The baby's head crowned.  His head came out.  He was as purple as a concord grape.  It was startling to see how darkly blue he was.  Nancy checked the chord.  I can't remember if it was around his neck or not, but if it was, she removed it.  The baby was in that position for several minutes, part way in, part way out.  I rested as best I could, euphoric, exhausted.  Then the last contraction came, and our son Dylan arrived in the world!  Nancy said what a beautiful girl she was, but my husband and I noticed that actually he was a beautiful boy!  I think she was at a hard angle to see!  Nancy assured us, because he had been so blue, "He was never not OK.  He was never not OK."  Those words have echoed through my head 100's of times since then.  I was thankful for her reassurance, though I'm not sure how anxious I had felt.  Her words turned it into goodness.

This picture is called Thirty Seconds Old.  I drew it from the photograph Mary took at that moment.

Dylan took a few minutes to begin nursing but quickly got the hang of it.  His sucks helped my uterus expel the placenta easily then Nancy sewed me up - I'd torn a bit again. 

I chose not to take an herb bath this time because I didn't want to leave the baby - that had been hard with Laura - so I watched as Nancy weighed and measured Dylan.  He weighed 9 lb.  He was born at 5:00 PM, about 9 hours after I'd woken up to start the day.

My mother, ever prescient, called about 15 minutes after Dylan was born and asked when she could come over and bring the kids to meet their brother.  We asked for a couple of hours so we could get settled in.  I was still so tired and not feeling great nausea-wise, so it was helpful to be able to rest for a brief time first.  We got settled in up in our bedroom, then Mom brought the kids.  We have a wonderful photograph of the kids climbing onto the bed to meet their brother.  They're full of joy and anticipation.  There's another photo of them sitting on either side of me.  I'm nursing Dylan and reading a book to the other two.  I remember loving the moment, even as I felt stretched a bit beyond my ability to satisfy all their needs. 

The next few days were tough.  My husband got the stomach flu as I was recovering from it, then the kids, then our au pair.  I guess the good part about it was that we took it very easy, resting most of the time, allowing ourselves to recover slowly and gently.  It was a lovely time.  Friends again brought meals, and Rita was a huge help.  It truly does take a village to raise a family!

Life with three remained busy and hectic, but Dylan was a fantastic addition to our family.  With him, we became complete.

Birth #2: at home

In 1989 I found out I was pregnant again.  I immediately began talking to my friends who had had home births to find out how to go about having one.  I was happy with the birthing experience I'd had in the hospital, but in the meantime I'd become aware that there were other options which could work better for me and my family. 

At that time (and I believe still today), there was only one midwife in town who would attend home births.  She has a physician back up (she must by law) and is allowed to attend births in hospitals, but her primary practice is with women giving birth at home.

I went for my first check up with the Nurse Practitioner in the doctor's practice - standard procedure so she could screen me to make sure I was a good candidate for a  home birth - i.e. healthy, not high risk, aware of what was involved, etc.  The next month I met Nancy, the midwife.  I liked her immediately.  She was calm, sensitive, no-nonsense but very caring and kind.  She examined me thoroughly and explained to me what she was doing and what was going on in my body.  She gave me plenty of time to ask questions and to express any concerns I might be having.  I felt completely cared for and heard and safe.  She made sure that everything was going well physically - that's one of the things that makes home births so low risk - the midwives really know their patients and screen them for problems thoroughly each time they see them.  They won't allow the women to try to give birth at home if there is the slightest hint of a potential problem.  Of course, emergencies arise at times, and that is a risk that one takes when having a home birth.  I decided it was worth the risk.  I felt very confident that things would go well.  It was a gut feeling.  I was right.

On August 31, 1989, I woke up feeling good.  It was a beautiful, clear, cool day - quite the anomoly in Richmond, VA at the end of August!  I began feeling contractions fairly early so called Nancy to let her know.  She suggested I call her again when it got more intense  and I wanted her to come over.  I dressed in a very loose blue dress with nothing underneath.  I walked around the house then went out into the yard.  I sat on the porch steps in the backyard and meditated on the shadows sifting across the grass as the branches of the tree blew gently in the breeze.  My husband cut a fresh rose from our garden and brought it to me.  I contemplated the bud opening and imagined my cervix opening like the bud.  I felt the contractions, but I didn't perceive them as pain.  Instead they were simply helping my body do what it needed to do to help me bring my child into the world. 

The contractions began to get stronger so we called Nancy again and told her it might be a good idea for her to come over.  It was around 10:30, I think.  My mother had come over to get Andrew so he could have fun while we were otherwise engaged.  Nancy examined me when she got there and found I was at about 6 cm, shortly before transition when it gets very intense.  Because I'd been able to walk around and move as I wanted to the whole time, I hadn't felt more than mild discomfort at any point.  I felt an urge to sit on the toilet.  Since I was in my own home, that was what I did.  Nancy and my husband sat with me as I blew air out and let the contractions flow through me.  I imagined the rose opening up.  Nancy lightly ran her hands over my legs in a motion that was oddly helpful.  She told me I was getting close and asked if I wanted to give birth there.  I said no.  I had an image of giving birth squatting in the bedroom upstairs so we made our way up there, inbetween contractions (not on a guerney in the middle of a contraction like the previous time).  It was wonderful not having any pain medication this time.  I was able to use the time between contractions to relax and rest and calm myself to prepare for the next contraction.  I evoked the images I'd visualized for so many months to help me stay calm and peaceful.  I breathed deeply.  I moaned softly.

Once upstairs, I sat on the edge of the mattress on the floor.  When a contraction would come, I would squat and lean into Nancy - she must be very strong to have been able to take my weight.  I was at the pushing stage. I roared with power as I pushed.  The wave subsided.  I rested.  Nancy had me touch the baby's head as it was beginning to crown.  Another one.  I squatted and pushed into the pressure pushing into me.  Nancy reached in and widened my opening so I wouldn't tear very much.  I pushed again.  I tore some.  I roared somemore. The baby's head rushed out along with the rest of her body.  I pulled her out of me.  I was the first human being to touch her.  (12:16 PM) I lay back into the pillows and gazed into her eyes for what felt like eternity.  She latched onto my breast almost right away and nursed for at least a half an hour.  In the meantime, Nancy sewed me up and rubbed arnica and goldenseal on my vaginal tissues so I wouldn't be so sore.  (It worked - I felt fantastic as soon as 2 days later!  Quite a difference from the first time when the doctor told me he would sew me up nice and tight so my husband wouldn't even be able to tell I'd had a kid!  That made it hurt each time we made love for the three years between babies.  Not a holistic way to go.  But I digress...)  We had opted not to have the baby, Laura Anne, get shots or eye drops or any of the invasive things babies normally get in the hospital.  The only medical intervention we did was for me to get an antibody shot.  I am Rh negative, and I needed to get a shot in case Laura was Rh positive so I wouldn't build up antibodies against Rh positive blood - if I were to get pregnant again, that would cause issues with the next baby whose blood my body would try to reject. 

Nancy drew a bath for me with a potful of wonderful herbs in it to help my body mend quickly.  I didn't want to let Laura go, but I went downstairs to take a bath and left the baby with her daddy so he could love on her like crazy.  That was when Nancy put her into a canvas sling and weighed her: 9 lb. 11 oz.  She was pretty darn big!  Laura began to cry and was difficult to soothe.  I got out of the tub and went back upstairs.  A short time after I got settled in, Mom and Andrew came bursting in the door to see the new arrival, bringing flowers they'd picked and arranged in a sweet vase.  Andrew came over to me and peeked in at Laura.  He was very sweet with her.  I don't remember his ever being jealous.

A couple of hours later, a friend came by and brought us some beef stew and Grands rolls that her husband had made for us.  It was the best food I'd ever eaten!  Made with so much love, so hearty, just perfect.  Friends brought us a series of meals for the next week or two so we could concentrate on just being with Laura and acclimating her to life with us. 

Giving birth to Laura the way I did, at home, without drugs, was the most empowering experience of my life.  I was completely conscious of what I was doing.  I had made clear choices about what I wanted and, thankfully, fate cooperated, and I was able to give birth at home with my husband and the midwife there, with complete privacy and freedom to do whatever felt natural and right to me.  There were no unnecessary interventions and Laura was born into a beautiful room in her own home.  We didn't have to be uprooted to go home.  We were home.  We were cared for wonderfully by Nancy and then by friends and family who made sure we were well taken care of. 

That birth changed my feelings about my body too.  When birthing Andrew, I hadn't felt like I was in charge.  The birth was done to me as much as I did it.  There were so many things involved I couldn't control.  With Laura's birth, I was in charge.  Not that I was in control - it would be foolhardy to suggest anyone is in control in a birth - but I was empowered to birth my baby the way millions of women before me had done.  I knew I could do it.  By myself.  Nancy supported me.  My husband was wonderfully present.  But I gave birth.

It's the way it should be.

I hope that women are beginning to take back their power in giving birth.  It is one of our fundamental rights, and it is a gift we give ourselves and especially our children to bring them into the world in this way.


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My brother just sent me a message with his memories of Laura's birth.  It's fun to see it from another perspective.

And right after the birth, Mom called me in my classroom at Benedictine High School, where I was teaching a German lesson on the first day of the academic year. I had just started off speaking German to this beginners' class, drawing my family tree on the board and talking about my family. "And this is my sister," I said in German. Then I made a gesture with my hands to indicate a big belly and said she was pregnant. One of the 9th graders - who is now one of Obama's bodyguards - tried to interpret, "She's fat?"


Then the phone rang. They (WE!) thought it was eerie when the news came that Laura Anne, 9 lbs. 7 oz., had just been born. Three of the students in that class were on my soccer team, which had its first practice that afternoon. Between school and practice, I went to see Susan and Laura and got the necessary information (though I still don't understand why people don't ask, "How cute is she?" They always ask, "How much did she weigh?")

As we ran our laps around the soccer field, one of them - who is now a Registered Nurse! - started chanting, "Laura Ann, 9 pounds, 7 ounces" and everyone joined in.

Two months later, the day the Berlin Wall fell, Susan was celebrating her 30th birthday. I used that event as an opportunity to have the German students learn how to write a birthday card, which we then gave Laura Anne's mother. On it you could see: Paul DeTrana, 147 lbs., Brian Lambert, 132 lbs., David Dart, 97 lbs. Or did we translate everything into kilograms for her?