Why I choose to Homebirth

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:
~Earthbabies
~Mothering homebirth article
~Mothering Reasons to choose homebirth article

Ryan's home water birth

Well, where to begin? I had resigned myself to having a hospital birth, hubby was worried that we are too far away from help if something went wrong and was totally opposed to a home birth. I think he realized that we would have to look at other options to hospital after a completely stressful visit to my now second OB.

The first one and I parted ways on NOT good terms as he was completely unprepared to allow me to have a birth plan or 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 dr anymore, needless to say I was not about to let him bully me into having a medicated, medically controlled birth, specially since my first had been born at home without any complications.

I changed OB’s only to end up with even more stress and this one saying I would probably need to have a ceasar as my placenta was low lying – this was at about 24 weeks – I had had an u/s 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 provincial one (state run) – but at least he is reasonable and would not try to bully me further.

Then as luck would have it I contacted a doula, who put me onto my mw, who was nearer to us though still and hour and ¼ away but at least a bit closer than any of the others I had heard of. I went to see her and we clicked immediately – she gave me the confidence to seriously consider home birth as an option. Hubby and I agreed (or rather I convinced him) that that would be the way to go and we haven’t looked back since.

My midwife was assisted by the doula I had originally contacted - they make a wonderful team. On the 4th May (Hubby’s birthday) I woke up feeling worried that I was feeling very little movement from the baby, and had not felt any during the night – he usually woke me up – I also found that he had moved from anterior to posterior position, so I could not find his heartbeat on my bebe sounds monitor. I started having minor, but regular (more or less) contractions at about 6:30 (by which time I was up and about – most unusual for me as I had battled to get up before 7:30 – 8:00 lately).

I phoned my mw after 7:00 and she suggested that I go to my dr for a CTG and just keep monitoring the contractions. I got hold of my dr and he said to go to our local hospital for the ctg – he is in our nearest town, which is small and only has the prov hospital, but after my experiences with OB’s on private hospitals I decided that my GP (whom I trust) and a small town prov hospital was the lesser of the two evils (he would only be a back-up dr anyway). I went for the ctg and all was fine, it did not pick up any contractions – though I did have two very mild ones, but babies heartbeat was fine and that was all I needed to know. When the sister at my dr's rooms looked at the printout, she said that the scanner had not picked up any movement ito the contractions and that it probably wasn't working, but that baby's heartbeat was great.

By 10:00 the contractions were stronger though still very short (about 20 sec) and about 7-10 minutes apart. I spoke to the Doula who said to have a nice warm bath and if the contractions don’t stop, we will know I am in early labour. I did this and had 3 contractions while lying in the bath – this was definitely it, I was starting to get very exited. I spoke to both the mw and doula and they were preparing to come out my way.

At this stage I should also mention that I had my GP, sweep my membranes on Tuesday and I had been taking 2500mg of Evening Primrose Oil (orally and vaginally for the past two weeks) – I was desperate to have Ryan (we had chosen his name when we first found out he was a boy at 19 weeks). I started to get things ready with the help of my son – who is 9. By 12 the contractions were about 2 minutes apart though still short (about 20 sec) this carried on till after one, Hubby came home at 1:00 and helped me set up the last bits and pieces. The mw and doula arrived at about 2:30, by which time I was needing to stop what I was doing and breathe through the contractions. The mw did an internal and said I was 7cm dialated – I could have jumped for joy – hubby and the doula got the birthing pool ready and I got in – by this time I had stopped checking how far apart my contractions were and just let the mw guide me. My contractions were pretty intense, but still only about 20-30 sec long. I got to get into the pool and it was the most amazing feeling of relief to float in the water. I lost all track of time, and was aware only of what was happening in my body. Hubby was standing behind me and I held onto his hand. At one stage I recall the mw saying to me to breathe slowly as I am starting to hyperventilate. The one time I almost “lost it” was when Liza mentioned after an internal that I had an anterior lip, fortunately it didn’t stay long as I was desperate to push by then.

Ryan was born at 15:32 with the membranes still in place over his head (born with the caul). He gave an almighty wail when he was lifted out of the water. I cuddled him for a while and when the cord stopped pulsing hubby clamped and cut the cord. He then took Ryan while I got out of the water and delivered the afterbirth. The mw then checked me, I had two small nicks, neither requiring stitching. Ryan and I had a bath after he was checked and weighed (3.18kg) and we got into bed to relax and get to know each other. Even though I don’t mention a lot about my hubby and Gillian(doula) they were an integral part of the ‘team’ that helped me deliver Ryan. They were simply wonderful and I am glad I got to share this experience with them.

We ‘planted’ the placenta under a rose bush, bought specially to celebrate Ryan’s arrival.

We would love to have another baby and plan to share the miracle of birth with my mw and doula again!!