home birth

Ye Old Fatso

I couldn’t be happier to report that this pregnancy has only gotten better within the last four
weeks. I have been more energized, more enthusiastic, and DEFINITELY feeling pregnant. I
definitely look pregnant too. Everyone from family members to strangers are commenting on
how big I am for being just over halfway through the pregnancy.

What’s it like to be told I look big? Well, I’m happy to report that, for the first time in my life, I
find it incredibly relieving and validating.

Have I necessarily enjoyed people telling me, “Wow, you popped early this time!” or “You’re
only 20 weeks?!” or calling me Fatso? To tell you the truth, no, I didn’t. However, I do truly
enjoy looking and feeling pregnant. But it’s not only what’s happening on the outside that
matters to me. The bigger I get, the more I enjoy pregnancy because of what’s happening on
the inside.

In my last post, I wrote that I was experiencing a lot of anxiety about this pregnancy in general,
but specifically around not feeling the baby move as early as I did with my first child. I am
overjoyed to say that now I am feeling the baby move literally whenever I sit down.
Who knew that getting kicked in the belly could be so comforting? It’s the best part of
pregnancy as far as I’m concerned.

Even going to visit the midwife is better at this point.

During our last visit, we ran through the routine – pee in a cup, weigh yourself, take your blood
pressure, and the “How are you doing” questions – but it is the prenatal massage that makes
my heart go pitter pat. At Sweetwater Midwifery, after you do “the medical stuff” you are
invited to hop up onto a massage table. Heidi measures your belly, and you listen for your
baby’s heartbeat. I can’t help but smile when I hear that quick thump-thump-thump-thump-
thump-thump. What I look forward to the most though, is the massage.

Heidi works around your stomach to help keep your large intestine unblocked, and your
muscles feeling relaxed. Then, you’re positioned on your side in preparation for what I believe
to be a heavenly backrub. I know there has to be something more medical than just relaxing
happening while she works away at your muscles, but when you get to have 30 minutes of
being cared for by a deeply capable and knowledgeable person without distraction (aka, a
toddler running around, or throwing balls at you, or threatening to break windows with, I don’t
know, anything), it doesn’t matter. The relaxation is the biggest benefit to my health as far as
I’m concerned.

The visits are super simple, there aren’t ultrasounds or beepy things, or invasive vaginal gazing
unless there is a need for it. Heidi’s office is a homey environment that feels less like a clinical
visit and more like a living room chat. The visits are intimate, they engender trust, and her clinic feels like a place where a pregnant woman can be a pregnant woman instead of a medical case.

From what I’ve read, that’s very uncommon for something as common as giving birth.

So, is pregnancy round two all doom-and-gloom like I made it out to be in the first post?

Absolutely not.

It’s only getting more and more beautiful with each passing day, even if people do call me Fatso
prematurely.

Homebirth or Hospital Birth? Find Your Happy Place!

We’ll start by emphasizing that a general operating rule amongst midwives is that a woman will deliver her baby best where she feels best and by best we mean safe, supported, and relaxed. We advocate for that with every woman who comes into the practice, especially if they aren’t sure where they’d like to deliver. That being said, a new mother might not know where she feels best – it could be in the hospital, surrounded by doctors and nurses, and it may be in the privacy of her own home surrounded by the things most familiar and comforting to her in her daily life, or it could be in a birth center which is a balance between the hospital and home – no beeping machines, but not your living room couch either, although it’s typically a very comfortable, homey space.

It’s important to clarify that birthing your child is not the ONLY component that a family should consider when deciding between a home or hospital delivery. Considering where you’ll be receiving your prenatal care is just as important as considering where you’d like to deliver. The entire process of being shepherded through pregnancy is how the foundation for comfort is set for your labor. If you feel supported during your pregnancy, chances are you will feel supported during your labor.

Whether you’ve had previous hospital births or this is your first child, you may be wondering whether birthing at home is the right choice for you. While nobody but you can answer that question, here are a few facts about home and hospital births that may help you decide where it will be best for you and your family to bring your child into the world.

1) General Health

If you are in good health, are committed to maintaining that good health for the duration of your pregnancy, and have a low-risk pregnancy, home birth is a viable option for you.

2) Medical Procedures

Most women don’t begin their pregnancy by saying, “I want to have an episiotomy during my birth,” or “I’d like to plan my C-Section right now.” If you are someone who would like to avoid medical interventions unless they are absolutely necessary, you might be interested to know some of the statistics about hospital births and medical interventions during delivery. One notable trend over the last half-century in deliveries is the rise in C-Sections. A recent study showed that planned home births had low rates of intervention, physiologic (vaginal) birth, and no increase in adverse outcomes even if they were transferred to a hospital.

Today, roughly 32% of all US births in hospitals are cesarean, making c-sections the most common procedure performed in operating rooms nationwide. As midwives, we operate with the evidence-based knowledge that the majority of planned homebirths for women with low-risk pregnancies happen without medical intervention. Birth is a normal human process that, when given enough time, can be achieved without induction, medication, or surgical procedure. We allow for that time by working with mothers where they are comfortable and by giving them the time and support they need to have an enjoyable, relaxed labor.

For more information on evidence-based care and the state of maternity care in the United States, visit the Evidence Based Birth ® Blog (it’s one of our favorites!).

3) Familiarity

Besides the aforementioned attributes to birthing at home, an exceptionally excellent part of a home birth is the comfort a woman and her partner will have in a familiar place where they are surrounded by people who they trust and love. Midwives provide truly personal prenatal care throughout the duration of a woman’s pregnancy. We don’t rush appointments, and we try to become as integral a part of your budding family as we can be (within reason). When a woman goes into labor under the care of a midwife, the only medical facilitators at her delivery will be people she knows and with whom she has established rapport. The benefit of being in your home is that you know where everything is, you won’t be around strangers, and you may feel more relaxed.

In a hospital birth, you may encounter some unfamiliar (and sometimes, therefore, unwelcomed) faces – nurses you’ve never met, or even a doctor you’ve never seen during your pregnancy – while you’re in labor. This can be stressful especially if you have experienced difficulties, or have existing reservations or fears about birth.

4) Breastfeeding and immediate bonding with your baby

In a recent study in Ireland and the UK, researchers found that healthy breastfeeding practices were strongly associated with homebirths in low-risk pregnancies. While there are many factors that contribute to healthy breastfeeding habits, and healthy sustained breastfeeding habits, several reasons such as decreased stress, and a simplified post-partum care process have been attributed to helping mothers and newborns to start on a strong foot in breastfeeding.

Additionally, there are fewer procedures that need to be done right away in a home birth than in a hospital birth, thereby allowing the mother and child the opportunity for more skin-to-skin time – a practice which has been proven to improve the transition and healthy development of newborns. This skin-to-skin time allows for biological bonding and it provides ample and early opportunities to learn to breastfeed for both mother and newborn. The process is relaxed in a home birth, and having one coach (the midwife) can reduce stress simply because there are fewer opinions and tactics being tossed around the room.

To read more about bonding after birth, visit UNICEF UK’s Baby Friendly Initiative website.

5) Cost

The average cost of a home birth in the United States is roughly 20-30% of the cost of a hospital birth, and will most likely be less than the out of pocket costs of a hospital birth as well. Furthermore, some insurance companies DO cover home births. So, it is likely that if cost is a factor for your family, delivering at home will be the most economic route.

At the end of the day, the only way to know if a home birth is right for you is if it feels right. Welcoming a healthy, vibrant baby and having an easy, peaceful labor is what we want for all mothers whether they deliver in the comfort of their own homes or the comfort of a hospital bed. The best and only way to ensure that outcome is for families to choose where they feel safe and supported, and to identify what practices align most with their values and beliefs. There is no wrong answer. Follow your hearts!