Exponent II Classics: Birth at Home

As someone who chooses medicated hospital births, I appreciate this author’s sentiment at the end of this piece that advocates choice for all women when it comes to this important decision.

Mary Ellen Sullivan
Arlington, Massachusetts
Vol. 5, No. 2 (Winter 1979)

     Gently, she was lifted on to me.  After the nine months of being with her, the months of feeling her little movements, the times we heard her heart beat, to see her sweet new body and to touch her with my hand filled me with such joy.
      She gave a little cough, a sneeze, and even a yawn.  She was looking at her father’s face close by her as he spoke to her.  The room was quiet and warm that June evening—we were home.  No one would yank her away, weigh her, wrap her, and carry her off.  The doctor would leave as would all the birth attendants, after they had finished helping me and straightening up.
      When my husband Douglas and I found out that a baby was coming to us, we were so thrilled and wanted to know all about what would happen.  To wait for seven months and then take a few classes at the hospital was just not enough.  Trying to figure out how to best learn more, I found the name of Homebirth, Inc., a Boston-based group.  If they teach people about having their children at home, I reasoned, I could learn what I wanted to know about pregnancy and birth.  I contacted them, found out about classes, and in the meantime, I read a book recommended by them, Immaculate Deception by Suzanne Arms.  Reading of the experiences of women giving birth in the hospital chilled me.  I realized then that only one of the births I had ever heard about first-hand had been what could be called a good experience.  And yet I was not willing to accept the idea of our trying to have a child at home.
      A few more weeks of classes, of meeting and talking with women who had given birth at home, and a visit to one of the obstetricians who had worked with Homebirth and would come to the home, encouraged us to consider a home birth ourselves.  We continues to read and study, especially Sheila Kitzinger’s The Experience of Childbirth.  The course of my pregnancy had been smooth.  My physical well-being seemed at a peak. No complications were indicated.  As the due date drew nearer, we purchased the supplies needed; we sterilized the sheets, towels, little clothes, we arranged to have a car and emergency back-up.  The four birth attendants we had chosen to help us came and spent an evening during which we went over what would and could happen and where the supplies were kept.
      In the last weeks and after the due date passed, we became more and more eager for the baby to come.  We certainly weren’t taking a natural birth at home for granted, but I hoped that we could be at home.  For years I had practiced deep breathing, and during the pregnancy, I had exercised and taken care of myself.
      The morning of that warm day in June, I woke to find the “bloody show.”  The time had come.  Douglas had an appointment that morning, and I can only remember being excited and thinking about the baby.  At 2:00 in the afternoon, I was lying down when my water broke.  An hour later, the first contraction took me by surprise. The strength of it was overwhelming.  “I can’t do it,” I told Douglas.  He held me and said he knew that I could.
      I showered.  We phoned the birth attendants.  One of them had arrived by 4:00 when the next strong contraction came.  They prepared the bed and I lay down, beginning to breathe deeply.  The contractions started coming, but not the respite I expected between each of them.  The labor was no longer painful, just powerful and so completely engrossing that I could no longer have dealt with anything else.  I wanted Douglas close by me constantly.  The other birth attendants arrived.  The primary attendant checked the fetal heartbeat and my dilation.  The doctor was reached, and when he arrived about 7:00, I was completely dilated and the pushing urge had begun.  The two attendants who stayed close by Douglas and me helped me with my breathing and relaxing.  The doctor wanted to do an episiotomy, but the attendants interceded for me and massaged the pelvic floor.  I could feel the baby’s head.  Another push by my body, and a little cry was heard.  The head was out.
       Emotion welled up in me as I heard that little voice.  Though my body was pushing effectively, I pressed hard too, and there was a tear.  Another brief push.  8:45.  A girl.  I could see her.  This new person was with us.  No one spoke.  She was so beautiful and well.
      In a little while, Douglas cut the umbilical cord.  I sat up a little and held her close.  She locked on to my breast.  I couldn’t take my eyes off her.  Later, we shifted a bit.  I pushed again a few times, and the placenta slipped out.  The attendants washed me, then the doctor gave me a shot so I wouldn’t feel the stitches as he repaired the tear.  I rested with the baby in my arms.  Her eyes were wide open and calm.  The doctor sat and talked to me, and then he went home.
      Too excited to rest, I got up and walked around a little, talking with the attendants.  They had some food, including real birth-day cake, and cleaned up.  The bed was made up and the baby’s bed and little clothes were ready, though she had already fallen asleep in my arms.  The attendants each said goodbye and they also left.  How much I appreciated all they had done. 
       Almost every account I hear of a birth is not like this.  The stories are of rude experiences better forgotten and/or physically debilitation for  both mother and child.  What I would like more than anything to say to a woman who wants to have a natural birth is that “you can do it.”  A woman should have the birth situation be as she wants it to be, whether in the hospital or at home, whether she must have a Caesarian or wants pain relief or monitoring or music.  Douglas and I recognize how blessed we were that as we took the responsibility for the birth of our child into our own hands, we were able to fulfill that responsibility—that our child did come to us in such a beautiful and peaceful way, and that we had each other for support always.
      Less than three hours after our daughter Mary Eleanor (Molly) Cannon was born, we also came to recognize the unexpected.  In our twenty-third floor apartment, we sat and talked at the kitchen table when the first alarm rang.  Fire, the only emergency that would place all of us in danger, had been my most dreaded fear when we decided to have a home birth.  Douglas’ brother had come up, and he helped us as we hurried to take the stairs to the ground.  We all walked down and out into the warm night air past first engines.  It was a small fire, as it turned out, but we decided to spend the night at his brother’s home.  We knew that birth begins a great adventure.

EmilyCC

EmilyCC works for a national non-profit and lives in Phoenix, Arizona with her spouse and three children. She is a former editor of Exponent II and a founding blogger at The Exponent.

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30 Responses

  1. Deborah says:

    I am deeply deeply ambivalent about birthing options. I don’t have children yet, but I do think a lot about the various choices that will (hopefully) befall me someday. I’m completely fascinated by home birth, birthing centers, water births, circles of women, embrace the pain, join the sisterhood of the ages. But for all other aspects of my life, I seek out the most cutting-edge medical care available. Now that I’ve moved, I’ll be driving over an hour every three months to visit the one dermatologist in the area who uses a certain technology that might be just slightly more effective in tracking my temperamental moles. Don’t know a think about the man’s bedside manner. So the other part of me says, Find the best trained (female) ob-gyn at the best possible hospital that can deal with any foreseeable possible complication. I honestly don’t know what I’ll choose.

  2. Craig says:

    I’m not likely ever going to be in any situation where I’m in any way responsible for where someone gives birth . However, in my opinion, a hospital birth with a highly qualified expert physician who has immediate access to any necessary equipment or drugs is always going to be the right decision. It’s the safest course of action, and that’s really the only thing I care about.

    The chances of problems aren’t very high, but when something goes wrong, especially when it’s not expected, it can go very, very wrong, (as with my birth).

    But I do think that the mother should have the right to choose, even if I think it’s not the best choice.

  3. Corktree says:

    This is so timely for me! We *just* switched from a physician based practice to a Birthing Center with a group of midwives and are strongly considering birthing at home in the next few weeks or so.

    It just feels so right, even though I really do love recovering in hospitals (especially with young ones already in the house). I love reading birth experiences. This one mirrors my own in some ways, but I’ve never been able to describe the indescribable that comes from my natural labor experiences. After this one, I intend to write it all down as soon as possible.

    I feel much the same as the author states. I want to encourage those who are considering an unmedicated birth and tell them “you can do it!”, but I also want to respect that everyone experiences labor differently and that what is right for me is not right for everyone.

    Thanks for posting this.

  4. TopHat says:

    I just had my second homebirth just this past Saturday. We went with that option because the first happy birth story I had ever heard was of an unassisted birth in Laos. I was in college at the time, so I hadn’t read many birth stories: I had only been exposed to my mom’s cesareans, which weren’t particularly happy, at least from what I remember mentioning. Anyway, it was such a revelation to me that birth could be something GOOD. While as Mormons we claim to not believe in the original sin, I still connected Eve with painful labor. Throughout my first pregnancy, I actually felt I might be sinning for hoping that my child’s birth would be positive- like I was pridefully trying to get out of the consequences of the Fall.

    Now, neither of my labors were painless- and particularly not the most recent- but they were uninhibited and peaceful. My first labor was the first time I actually felt connected with my female ancestors, and my second labor was one of the only times in my life where I actually “heard” the Spirit guide me. I’m glad I went that route. I know that a homebirth isn’t the only way to feel connected to the Spirit or with t=your ancestors, but for me, I don’t think I would have be able to have those experiences if I wasn’t in my own home.

  5. Deborah says:

    Corktree: we’d be happy to publish your birth story here of you decide to write about it… I love hearing these stories…

    Tophat, thanks for a sharing… I’d love to hear more about heat you mean by feeling connected to your ancestors… It’s a sentiment live heard quite a bit from women who have chosen un,educated births, and I always want them to unpackage a bit kore what that means for them…

  6. Deborah says:

    “what” not “heat” … And I’ve not “live”… Darn autofill on the iPad!

  7. Kelly Ann says:

    Tophat, congratulations on the birth of your baby. I am glad to hear it went well and was such a good experience for you. As I did not get your personal information at the FMH snacker a couple weeks ago, if I can do anything to help, please let me know. True Mormon style, I’d love to bring you a meal from the bloggernacle. I’m serious about this as I think you are only 20-30 minutes from me. And don’t worry, it wouldn’t be a casserole or anything truly oddly Mormon. You can email me at kalanierATgmail

  8. Corktree says:

    “While as Mormons we claim to not believe in the original sin, I still connected Eve with painful labor.”

    This is similar to something I believed until recently as well. Even though I prefer the unmedicated experience and “enjoy” the process of labor to a certain point, I always believed that it was meant to be painful, and that overcoming the pain was the point of the experience. After reading and researching this time around, I don’t think I believe that anymore. I’ve come to believe it’s our fear that elevates the discomfort to such painful levels, so I’m trying out hypnobirthing this time to see if it makes a difference in how I feel. I can’t wait to see if there really is a difference or not.

    And I would love to be able to share my experience with readers here (it’ll motivate me to actually write it this time).

  9. Naismith says:

    “It’s the safest course of action, and that’s really the only thing I care about.”

    Actually, that’s not true. The medical literature suggests that the safest place to have a baby is in a birth center. Unfortunately, that option isn’t available to many women in the US. My daughter in Ohio only had the choice of hospital vs. home (although the laws have changed there in the past few years).

  10. EmilyCC says:

    Deborah, I’m with you…I’m on #3, and I still am conflicted about how I give birth.

    Craig, I think your ideas are similar to mine in what keeps me from making the leap to homebirth. Our first child wasn’t supposed to have a complicated birth, but gosh, was I glad we were in a top NICU hospital after he was born. (Then again, the research I’ve done since then could indicate that his complications were caused by the type of birth I chose. Just. Can’t. Win!)

    Corktree, I do hope you’ll consider writing about your experiences for The Exponent or the magazine!

    TopHat, congratulations! I hope you’ll consider writing something, too (when you’re up for it 🙂 ). And, my guess is Deborah’s iPad autofilled “un’educated” when she meant “unmedicated” because such word choice is so not Deborah 😉

    Naismith, it is sad that the choice just isn’t available to every woman. We lost our last birthing center in Phoenix a few years ago, and it did feel like a nice bridge for someone like me who wasn’t ready to birth at home, but might have been able to wrap my head around the idea of a birthing center.

  11. Deborah says:

    Crap. Yeah, unmedicated… Time for bed…

  12. Craig says:

    @Naismith

    I’d be interested in that research. Do such centres have surgeons and equipment on hand for emergencies?

  13. Corktree, I did Hypnobirthing with my second and third children, and I had a great experience! I did it the cheap way (practice with the relaxation CD at home) rather than the expensive way (hire a hypnobirthing doula, attend classes), and I still feel like it made a big difference.

    Oh, and I delivered all three children in the same hospital with the same midwife. My only wishes for how it could have been different? Bigger jetted tub for laboring in, and better bed. A couple of nights in a hospital bed always leaves me feeling worse than when I went in.

  14. FoxyJ says:

    I often feel that I had the opposite experience of many people my age. My mother had my older brother in the hospital and then had the other four of us at home. This was during the late 1970s/early 1980s, at a time when home birth in CA was illegal and actually under attack by the authorities. So I grew up with stories and pictures of our home births, and with the attitude that birth is a spiritual, natural process that in most cases can be done at home. My mom gives a copy of ‘Spiritual Midwifery’ to everyone she knows (it’s a great book)

    When my husband and I were expecting our first I just assumed I would have an unmedicated birth. He was uncomfortable with home birth, and since it takes both partners to be successful we found a good CNM and a supportive hospital. Then we kept finding issues with my uterus during pregnancy and my baby wouldn’t turn from breech position. After listening to advice from my midwife and prayer I scheduled a c-section for a few days after my due date. During the surgery we discovered that my uterus is misshapen–a complication that some times doesn’t impact the ability to labor and some times does. My second child was also born by c-section in a very traumatic surgery after a placental abruption. I just delivered my third (and last) by c-section, but I felt that it really was as ideal as it could have been as far as hospital and family support.

    Anyways, I don’t know why this comment is so long. I guess every one likes to talk about having babies 🙂 My mom has been an amazing advocate for me and has never questioned my decisions. She and I are both big proponents of home birth and of making birth more intervention-free. I also believe that we need to acknowledge that birth is often a process that we cannot fully be in control of and much of it is based on faith. We need to have options and fully support all of the options, but I also feel that many women aren’t given a good idea of the potential for how things can be. Part of me hopes that some day there really is something like celestial childbirth so I can understand the empowering feelings of labor and really ‘birthing’ a baby, since I’ve never had the chance.

  15. Keri Brooks says:

    Congratulations on the birth of your child, TopHat!

  16. TopHat says:

    Sorry I disappeared and didn’t respond! This whole newborn thing, you know?

    Deborah- It was a really long labor, so I asked my husband for priesthood blessings a couple of times during it. In one of them, I was told to remember the strength of the women who came before me and that their strength was my strength. My parents are both converts to the church, so I don’t have many family history stories, and in fact, to some extent, they have separated themselves from their families for various reasons- and actually my decision to have the homebirth was divisive between me and my mom. So I went into the birth very alone in the extended family sense. Hearing that in the blessing made me think about those women who were “just names” and made them more real for me. In labor, I imagined them with their hands on my head blessing me. On another level, I actually felt very connected with Eve- who had never given birth before and was really alone with just her husband. Her only assurance might have been that she’d have to live to make another baby someday, which in labor, isn’t very assuring.

    Kelly Ann- I’ll have to email you. 🙂 I’m in Oakland.

    Corktree- yes, tell us! I haven’t tried any birthing methods and after this time, I think I might for any subsequent births.

    And thanks for the congrats everyone! Now I will go get some sleep. 🙂

  17. Conifer says:

    I love birth options! With my first I was in a hospital with a midwife — good, but not exactly what I had hoped for. With my second we went to a birth center and it was absolutely wonderful — we got a candlelit water birth. It was seriously everything I ever wanted in a birth. I loved knowing that I had midwives who would actually consult me before doing anything (unless it was an emergency and there was absolutely no time, of course). In the hospital, even with a midwife, things were done to me without my permission. Hospital birth comes with serious pros for a high risk birth, but they cause a lot of problems and try to take away a lot of rights, too. It’s a trade off. I’m glad every woman is able to decide for herself based on what she feels is best (at least in the US).

    For anyone interested in some research-based reading, look into Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First by Marsden Wagner.

  18. Naismith says:

    About the research….

    A massive study investigating North American birth centers (n=11,814) was published in the New England Journal of Medicine in a series of articles from 1989 to 1992. Here is an overview:

    http://www.ncbi.nlm.nih.gov/pubmed/2687692

    A more recent study in Australia is here:

    http://www.ncbi.nlm.nih.gov/pubmed/20402719

    “Do such centres have surgeons and equipment on hand for emergencies?”

    The assumption is that such things are available to women in hospitals, and that may not be a fair assumption. When I birthed my fourth child in a hospital, I told the nurse I was ready to push, and she replied, “No, you won’t be delivering until (three hours later)” and she sat down on the couch. My husband, who knows me, was headed out the door to ask for help but ran into the doctor, who took one look, understood I was ready, and baby was born a few minutes later.

    Birth centers do have an equipment for infant resuscitation, etc.

    From what I have read, the reasons that birth centers are superior is because (1) less inappropriate intervention (and thus promoting healthy labor by allowing continued nutrition and less tethering to monitors), (2) better staffing ratio, (3) more knowledge in dealing with unmedicated births (which was the issue in the story I just told).

    Also, the long-term outcome from birth centers is so much better. That (drastically) lower C-section rate means easier subsequent deliveries, and the much higher breastfeeding rate is also important.

    A huge caveat in looking at comparisons between hospital and birth center births, in that of course the high-risk cases are transported to hospitals. The better studies (including those above) account for this and compare followup of intention to birth only, and have criteria for eliminating known high-risk births from the analyses.

  19. Emily U says:

    Thanks for posting this – I love birth stories, especially while I’m pregnant.

    Reading about home births makes me a little sad because I would really like to go that route, but DH is really uncomfortable with the idea and I don’t want to put him through a situation he’d be extremely anxious about. So I’m having another unmedicated hospital birth. Birthing centers are all too rare. I’m in the 3rd largest city in the US and there isn’t one anywhere near me 🙁

    janeannechovy- I’m trying hypnobirthing techniques as well. My sister and midwife recommended it, so it’s nice to hear it worked well for someone else!

  20. Emily U says:

    P.S. It’s pretty amazing that in this case from 1979 a doctor attended the home birth. I bet you’d never find an M.D. who would do that now.

  21. EmilyCC says:

    janeannechovy, hypnobirthing research is on my to do list–I’m so glad to hear it worked well for you!

    Foxyj, thanks for sharing your multi-generational birth experiences. I’d imagine your brother was born around the same time as this essay was written–is that right? If so, how interesting that each side of the country had such different reactions to home birth.

    Conifer, thanks for the book recommendation!

    Emily U., I thought it was so interesting that a doctor was present at this birth. I wonder how often that happens today, too.

  22. Deborah says:

    Thanks, Tophat. Sounds so beautiful… I think about my grandmothers and great-grandmothers a great deal, and I suspect those thoughts will be heightened if/when I give birth or otherwise bring children into our family. The matrilineal chain grows subtly more important as time passes…

  23. How good was my hypnobirthing experience? This sums it up: 6 cm to baby in 17 minutes. My third child was a little longer, but still I think my pushing stage was only 20-25 minutes. The L&D nurse with my third said they have to completely ignore all their training about what different stages of labor look like on a laboring woman when they’re dealing with a hypnobirther–they’re much calmer than the nurses are used to.

  24. Naismith says:

    I did respond to Craig’s request for scientific studies by posting some yesterday, but it was caught in moderation (perhaps too many external links since I did provide links right to the medline abstract0.

  25. Craig says:

    @Naismith

    Thanks for the info! You’ve definitely changed my mind.

  26. TA says:

    What a beautiful story. I’m currently in the middle of my education and keep debating which way to go. This seems like the place to ask my questions. Does anyone here know if there are any states where Dr.s or CNMs are allowed to do home births? In most places I have heard of it is prohibited, and only lay midwives may attend home births (which really doesn’t make any sense if the politicians really are concerned about the safety aspect)
    Thanks

  27. TopHat says:

    TA-
    You’d have to look it up. In both CA and UT (and I only know b/c I’ve lived there), CPMs can be certified through the state and carry many things like oxygen and pitocin. I know in Illinois, CNMs are the only ones that are “allowed” to attend homebirths, but because of regulations, it’s rare to find one who does. And almost anywhere you can find (with varying degrees of difficulty) midwives who have gone to midwifery school, but who choose to not be certified through the state for whatever reason (perhaps the state doesn’t certify midwives who’ll attend VBACs, but that midwife feels that that sort of restriction is unnecessary so she might work without certification so she can provide that service). You’d really have to go state-to-state and look it up.

  28. heidelade says:

    In Texas a CNM or CPM can attend a homebirth, though I rarely hear of CNMs attending since they must have a back-up OB (and deal with any restrictions placed.) I am aware of a local OB who attended a birth center delivery of twins – the midwife caught & the OB hung out as support. 🙂

    We’re expecting #6 and we’ve tried a range of things (hospital, CNM, perinatologist, epidural, no meds, stat c-section, VBAC, birth center, etc.) I’m incredibly grateful that we have those options in our area and that our care providers really, really listen to us. When we needed extensive medical intervention we wanted that level III NICU, in house anesthesiologist, and high risk specialist – but when we were low risk we appreciated the OB sending us on our way and telling us to stick with our midwife.

    Each pregnancy for us has involved a lot of discussion, research, prayer, and sorting out what felt best for this birth and this baby. Sometimes that meant the hospital, sometimes it meant elsewhere, always acknowledging that we would be surprised by some aspect of the experience and that things rarely go as envisioned! I try to not take for granted that I have options and a care provider I trust – I wish every mother had that.

  29. Jenne says:

    Emily, thank you for posting this classic. I almost wonder if this was just for me. 🙂

    I recently tried to write an article like this though my emotions are so strong on the issue that I struggled to express my experience and my beliefs on why I have made the choices in birth that I have.

    My first birth was unmedicated in a hospital and I felt like it was a potentially very dehumanizing experience as the midwives were trying to manipulate me in very unethical, insensitive ways to do what they thought would be fastest, easiest and most convenient for them. I was traumatized by the experience and suffered from PTSD. The flashbacks of my son’s birth haunted me for months afterwards and I struggled to shake the anger.

    In preparing for another baby, I doubted my ability to trust any maternity care provider and as I learned about birth options, the idea of unassisted birth really appealed to me on a spiritual level. My second baby was born at home without a midwife in attendance because I felt the surest way to not have any one assist me was to not have anyone there. Like the author of this article said, I felt blessed to take the responsibility of the birth of my child into my own hands.

    I find it very disheartening to learn of the political efforts underway to make the type of birth I sought for myself illegal. The licensure requirements dictate that midwives practice in a way that I am not comfortable with and in order to protect their livelihood, I feel that I have to consent to treatment and monitoring that I otherwise would refuse. If that is what I have to decide between, I feel like a state medical board is dictating my personal freedoms as a parent and that my rights as a woman are endangered. Midwives are compelled to either practice illegally (without a license) or to obtain the license and practice illegally by not complying with the licensing requirements. If midwives aren’t willing to do either of those, they are liable to violate a woman’s right to self-determination.

  30. Deborah says:

    Heidelade, I’ll be contacting you for advice when it’s my turn!

    Jenne, what a fascinating story of two births. Thanks for sharing.

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