'I'm planning a home birth'.
These are words I truthfully never thought would leave my lips - BUT - it's true! I’m planning a home birth for baby brother in September and I am surprising myself with the anticipation I have for this birth! A loving welcome earth-side in an environment where I’m calling all the shots, with a care team that has nearly all the tools that would be available to us had we chosen a hospital birth. I laboured at home with Aspen until the eleventh hour (we almost had a baby in the car on the way to the hospital!), so planning to give birth at home this time is feeling a lot less stressful and safe.
But lets be really honest here, there are some big questions I had and you may be thinking as well, the biggest one for me being: “But what isn’t available to you as a mother birthing at home vs. in the hospital?” This and a few other similar questions were at the top of my list as I grilled my Doula, Morag Hastings, during our interview. She gave it to me straight which I really appreciate: we won’t have an operating room or a Pediatrician on-site.
Ok, so no Pediatrician - why do we need one of those? As she explained to me, Pediatricians could be helpful guys to have around in the event that baby isn't breathing, or isn't breathing well on his own once he is born. He may need to be intubated, and while a midwife is trained to do this, she wouldn't have the same experience as someone at the hospital who would be performing intubation on a more regular basis. So, in the event this happens at home with no Pediatrician in sight, the midwife can bag and manually supply oxygen to baby and can either continue to do this until a paramedic arrives, if necessary, or even call an ambulance and manually provide oxygen until you can safely get to a hospital to address this. Of course this is rare, but we want to be prepared for any and everything. OK, Pediatrician puzzle solved.
Obviously, no operating room at home and we have all seen dramatic movies or TV shows where 'baby is in distress' and we need to get baby out pronto. So what do we do if we are at home and an Emergency C-section is needed?! Well, as my doula explains, this isn't really how this goes in real life birth. When mama is in labour, her care providers who are educated and experienced in how healthy births progress monitor her labour and contractions. In British Columbia you have 2 midwives at your side when electing home birth. I have also chosen to hire a doula, so there will be 3 incredibly skilled and trained women monitoring my labour. These women are your safety net and can identify well in advance of a true emergency if and when it may be necessary to get to a hospital.
Also important to note is that once you have informed your midwives that you are in labour, they relay this information to the hospital who pulls your file and is aware that you are birthing and prepared to receive you should that be necessary. And if that becomes the case, there is actually a specific protocol in place for birthing mothers and/or newborns that require Emergency Transport. Here is a great document with more information on this from BC Women's Hospital.
For me, the journey to the decision to have a home birth has been a long one. I've suprised myself with how far I’ve shifted in my beliefs and feelings towards birthing and what I’m now comfortable with. Certainly after having given birth once, my confidence in my body’s beautiful ability to grow life and birth has increased. But as an American girl now living in Canada, I am amazed by how I probably never would have chosen this path if I were still living in Portland. Why? Well first, my sister has had three hospital births in the States and I was present for each. They were all beautiful and started a story for me that this was how I would one day birth my babies.
However, there are huge differences in how midwifery care and home births are regulated between the two countries, specifically, "Canadian midwifery is regulated at a federal level and midwives are not allowed to treat women who have serious medical conditions or are likely to have complicated births (like mothers carrying twins) at home. [Further], home birth in Canada is integrated into the obstetric system.” (Smithsonian.com).
This article contains a wealth of information that helps me understand why I had so many fears surrounding the idea of home birth. It's really not as safe in the States currently for all birthing mamas due to the lack of regulation, and in almost half of the U.S. home birth is practiced outside the law. "In Canada and many other developed nations, [home birth] can be as safe as birth in a hospital for some women. But in the United States, it’s very dangerous compared with hospital birth. That isn’t because home birth is always more dangerous in all cases—it’s because home birth in the United States isn’t part of the medical system, and not all midwives are equal in terms of their medical education." (Smithsonian.com).
Each birth is unique and preparation for birth should be both informed and also judgement-free. But let's get rid of the mindset that birth is terrifying and something we should approach with fear and anxiety. Birth is the most miraculous thing we may ever experience in this life; whether that experience is as the birthing mama, a father meeting his child, or another loved one experiencing the start of a new life. It is beautiful and transformative. Yes, it is painful - as in next level painful - but it is not without reward. Women have been giving birth for thousands of years and it is quite spectacular to be a part of history, literally contributing to the continuation of human-kind. I mean seriously, think about how incredible that is!
Today being Mother's Day, I cannot help but be reflective on my own mother, my son, my baby on the way and the whole journey. What a precious treasure life is, as well as the ability to create it.