Friday, January 1, 2010

Baby, you can drive my car

O Faithful Readers (all three of you), I would like to take this opportunity to introduce you to Mr. Canuck. There are two important points you should know about him:

1. He is a banker and wears suits and ties to work. He has an encyclopedic knowledge of literature and classical music, especially opera. He votes Conservative.

2. When he was in college, he crowd-surfed in the mosh pit at a Nine Inch Nails concert and someone bit him.

I adore this man.

And one of the many reasons I adore him is because he is very open-minded and is always willing to consider new ideas, even if they seem wacky at first. Ages ago, when I first brought up the idea of having a home birth with a midwife rather than a hospital birth with an obstetrician, he was extremely skeptical, to say the least. But we both researched the topic pretty extensively and thought about it quite a lot, and now we're both convinced that this is the way we want to go.

Now, home birth has gotten quite a lot of bad publicity, but that is (as usual) due to the crazy minority rather than what actually tends to happen. I am absolutely not planning an unassisted birth, or "freebirth." In my opinion, that is nuts. Yes, giving birth is what women's bodies were made to do. Yes, plenty of women around the world give birth unassisted every day. But you know what? A LOT OF THEM DIE. I think it is naive at best and downright insulting at worst for women in the first world to compare themselves to third-world women who have no other choice. And I think that deliberately choosing to give birth with only self-administered prenatal care and no professionals of any kind in attendance is child endangerment. There, I said it.

So I'm not doing that. The other thing I am not doing is hiring an unlicensed, self-trained midwife. I am lucky enough to live in a country, and in a province of that country, where midwifery is not only strictly regulated but is covered by the provincial health care plan, including home births. It's downright mainstream! Practically.

There are a lot of reasons why I chose to go this route. Mostly it was because the very idea of a medicalized birth in a hospital scares the bejesus out of me. From what I've learned through reading and talking to women who have done it, it seems to be just a slippery slope of one intervention after another. You go into it expecting to have a natural birth, but the OB decides that labor isn't progressing fast enough so they put you on Pitocin. This makes the contractions so powerful that you can't stand it anymore, so you get an epidural. And so on and so forth until, about 30% of the time, you end up with a C-section. (Those statistics are for the United States, but Canada is similar.)

And besides all that, a hospital is a stressful environment. Nobody likes being in a hospital. It's full of activity and bright lights, you've got people bustling in and out of the room all the time, your actual OB may or may not even be there for the birth, and the nurses might be awesome and supportive or they might be rushed and impatient. Not to mention the high risk of infection that comes with any hospital stay, and having to follow hospital protocols, and getting conflicting advice from the assorted maternity staff. None of that sounds the least bit attractive to me.

Now, I know that it doesn't have to be that way, and quite often isn't. I know that an awful lot of women have had very positive experiences giving birth in a hospital. It's just not what I want to do.

On the other hand, giving birth at home is a very attractive option for me. And the statistics support me on this. Infant and maternal mortality and morbidity rates are both slightly lower for home births than for hospital births. Interventions of any kind are of course drastically reduced, and unnecessary C-sections just plain don't happen.

Being in a calm environment is also important to me. There is some evidence that being in a stressful place like a hospital can actually slow down labor. (I could try to explain the physiological reasons for this, but I wouldn't do a very good job of it, so I won't. Basically it's all down to the autonomic, specifically the sympathetic, nervous system - the "fight or flight" response.) At home, I'm in my own comfort zone, I can wander around and contort myself into whatever weird positions I need to in order to make myself feel better, I can get in the bathtub to relax, I can even have something to eat if I want. Everything can proceed as nature intended it to.

As for safety, I'm not even a little bit worried. We live very close to a major teaching hospital, so should anything go seriously wrong, we can be there in less than thirty minutes, and the midwife will of course have called ahead so they'll be ready for us. And for most situations, she's perfectly capable of taking care of it herself. For example, when Mr. Canuck was born, he had aspirated some amniotic fluid and needed resuscitation to get him breathing. That is something the midwife can do with no trouble at all. Should anything at all happen that is outside her abilities, she can recognize that and call in the big guns.

All this, of course, is assuming that nothing goes wrong during the pregnancy itself. If should develop, say, gestational diabetes or (god forbid) pre-eclampsia, home birth ceases to be an option. It's just not safe, and a good midwife will recognize these conditions and hand me over to an obstetrician.

Of course, there are all kinds of other people out there who can explain this far more convincingly and eloquently than I ever could. Here are a few of the books I've read that got me to this decision:

Your Best Birth by Ricki Lake and Abby Epstein
The Doula Guide to Birth by Ananda Lowe and Rachel Zimmerman
Ina May's Guide to Childbirth by Ina May Gaskin

Basically, like all parents, we want what we feel is best for our baby and ourselves. Mr. Canuck and I believe that, given our own personal preferences and beliefs, a home birth is our best option. If something goes off the rails and we end up in the hospital anyway, and even if I end up having a cesarean section, we will know that we did everything we could before that. The main thing is that we come out of this with a healthy baby, and we're convinced that this is the best route for us to take to get there.


Aldi said...

That makes a whole heap of sense to me. There are degrees of stress-inducing factors with hospitals, of course (when my cousin gave birth, she had her own, very intimate space, the nurses were super-lovely and it was all very relaxed and non-stressy; and my mother lucked into a really progressive - especially for the 70s - hopsital that advocated natural births and worked with alternative medicine and music and cosy & personalised surroundings), but by the very nature of the place, it has to be somewhat impersonal, since they've got loads of patients and have to give priority to medical care over making every one feel perfectly at ease. With a trained professional but within your own familiar surroundings and in your own comfort zone, you've got the best of both worlds.

Elizabeth said...

i think that's a wonderful choice. in fact i'm a little jealous. i would have loved to have been able to do something like that, but fate intervened and things ended up just about as opposite of that as possible. so my only little bit of advice is this: plan on this, but don't skip over the section in the preachy pregnancy books that explains about different emergency procedures. and if it's the same in canada as it is here, i would suggest taking the prenatal tour of your local hospital, just in case.

highlyirritable said...

Oh, how I loved my midwife! Unfortunately I couldn't keep her (I didn't put her in a pumpkin; I developed pre-eclampsia.)

Congrats and yay! to the our country handles choice for women and birthing. (Fellow Canuck here)

Also, was it the bite that turned him Conservtive? :)

Amanda said...

haha, it may very well have been! ;)