by Annie Austin
While most doctors will tell you that giving birth is a medical event which needs to take place in a hospital, with doctor in attendance “in case something goes wrong”, there is a whole range of alternatives out there. From having baby in a hospital with a midwife instead of doctor, to unassisted childbirth. With a whole spectrum of options in between.
Thought I would start with the birth of my second child. I had resigned myself to having a hospital birth, my husband was totally opposed to a home birth. He was worried that we were too far away from help if something went wrong. I think he realized that we would have to look at other options to hospital birth after a completely stressful visit to my now second OB. The first one and I parted ways on rather bad terms as he was completely unprepared to allow me to have a birth plan or to have any say whatsoever in the kind of birth I wanted. He said we would either do things his was or he was not prepared to be my doctor anymore. I was not about to let him bully me into having a medicated, medically controlled birth, especially since my first had been a home birth without complications. I changed OB’s only to end up with even more stress and being told I would probably need to have a c-section as my placenta was low lying – this was at about 24 weeks – I had had an ultra sound at 19 weeks and my placenta was nowhere near low lying. To cut a long and boring story short, the two OB’s know each other pretty well and both have an incredibly high c-section rate.
So there we were 25 weeks along and no care giver, I was desperate enough to consider using my GP who operates from the only hospital in our nearest small town – a state hospital – but at least he would be reasonable and would not try to bully me further.
I decided to look at other options, there had to be something better than the options I had considered thus far. Even if it meant me giving birth in Durban almost two hours drive away. I found a midwife in Ballito, not as far as Durban, but still over an hour away. I went to see her and we clicked immediately – she gave me the confidence to seriously consider home birth as an option, after all my first pregnancy and labour had been straightforward. My husband and I agreed (or rather I convinced him) that home birth would be the way to go and we haven’t looked back since.
Our son was born on the fourth of May, after an amazing labour assisted by a midwife and doula. I used a birthing pool for pain relief and was allowed to labour at my own pace. Ryan was born in water, with the membranes still intact. I was able to nurse him as soon as he was ready, he went straight into daddy's arms and was never left alone to fend for himself for one second.
After the birth we got into the family bed and got to know our youngest son better. Our oldest son was present to meet his new brother and the whole day was relaxed and pleasant. And I never had to eat hospital food!
Compare this to how most birth happens in a hospital. Firstly there is the drive to the hospital, in our case 40miles along bad roads, then having to get checked into hospital. After arrival, spending time on your back attached to monitors, and being examined by a midwife and nurses you have never met before.
If all this is not enough to stall labour, then chances are that the constant interruptions and offers of pain relief and IV needle in your arm would be. Not to even mention the fact that you are not allowed anything to eat or drink but clear fluids – just in case.
If you are one of the lucky ones, labour will proceed as expected - doctors expectations that is - not yours. If your membranes have not ruptured, then labour will be ‘helped along’ with rupturing of membranes. This often has the effect of speeding labour up and making the whole process more far painful.
Labour is given a time limit and if things take too long or start to slow down - due to all the interruptions - then drugs to speed up labour are given. Chances are that this will lead to the mother needing pain medication, as the labour inducing drugs cause harsher and more intense contractions, forcing baby out into the world before it is ready.
Due to the drugs extra monitoring is required, mother is expected to lie on her back so that baby’s heart rate can be monitored. Lying on her back not only makes for a more painful labour, but will also have a negative effect on baby’s heart rate.
If baby is seen to be in distress – possibly due to drugs given to the mother, or due to mother lying on her back, words like emergency c-section or forceps delivery start being bandied around.
What started out as a straight forward birth, has been turned into a medical emergency. Unfortunately most doctors are taught to deal with medical emergencies and not healthy mothers giving birth to healthy babies. One intervention leads to the next.
Add to this the risk of infection from other patients, risk of kidnapping (a common occurrence where we live in South Africa) and homebirth starts looking like a far better option.
These are only two of the options available to moms, there are many great free-standing birthing centers available – these are staffed by midwives and doulas. Some hospitals are open to independent midwives attending births instead of doctors. On the other end of the spectrum is unassisted childbirth where the mom chooses to labour at home with only her partner present without any medical intervention whatsoever.
Further reading on homebirth and birth stories:
~Mothering homebirth article
~Mothering Reasons to choose homebirth article