October 17, 2013

Why we are choosing a home birth.

Week 34
October 7 - 13

Genevieve is almost 5 pounds and about 17.5 inches long. 

Only 3 weeks until we are full-term. And 6 weeks until her 'due date'!
This post has been bubbling up inside of me for over a year. It is a small piece of my heart. Many have asked me, “Why are you choosing a natural home birth?” So I decided to do my best to explain the reasons why our family is choosing this method for our daughter’s birth. It has taken me a long time to actually put it all into words because it is such a sensitive topic. I know this post is long, but I hope it is helpful in explaining our take on home births.

Important Disclaimer: 

I have strong convictions regarding birth. However, I recognize that many may have differing opinions and birth does not always go as planned. Although the birth of a child is an extremely intimate and important moment in one’s life, it does not dictate the value or worth of the mother. When sharing birth stories and birthing experiences, I believe that all women should be validated and encouraged. Ultimately a healthy mom and healthy baby is the end goal and I don't want to diminish one mom's experience just because they may not have had a 'natural' birth. I want to honor every birth experience because I know that most women make decisions based on the information they have in hopes that it is the best for their baby. I have no interest in engaging in combative dialogue. My heart is simply to share my thoughts on a topic that many people may not know much about. 

Where my little girl will sleep the day she is born. This Moses basket was the one that Michael and his brothers used as babies. Since then my nephew and niece have used it. Now it is Genevieve's turn. It is important to me that she is close to me and we are excited to share in the family tradition.
Pregnancy is universally recognized as one of the most spiritual experiences, with birth as the sacred culmination. Growing a child and bringing life into this world should be celebrated surrounded by family in a safe, comfortable environment. Therefore, for educated, low-risk, healthy mothers, under the care of an experienced midwife, their home is the best context for allowing this to happen. Michael and I believe that birthing at home is the right decision for our family.

So for me, it all started on October 6th, 2010. 
I was invited to my first birth, a home birth. That day will forever be one of the most impacting days of my life. Seriously, it is up there with my wedding vows. I never knew anything about birth, especially a natural home birth. But standing in the Cooper's master bathroom watching Sarah give birth to Henri changed my life forever. I saw what birth was like when left uninterrupted. It was holy and absolutely awe-inspiring.

It's been 3 years since that experience. Since then I have been part of 2 home births and 2 hospital births. That’s not many, but enough to get me fired up and passionate about this field. I have read countless books, watched every documentary I could find, I've sat with any mom willing to share their birth story, and I started my doula certification. I've soaked in so much knowledge. And 8 months ago we found out we were pregnant and it is now time for me to experience firsthand everything I have learned.

We did not come to our decision to have a home birth haphazardly. My husband and I have done years of research on the type of birth experience we hope to have. I find it fascinating that people put so much time and energy researching a new car or computer and yet don't consider their options with the birth of their child. Surely our children’s arrival on earth deserves as much attention as researching the pros and cons of iOS7.

And how blessed are we that we even have options?! It is amazing that in our country we can choose to have an obstetrician at our birth in case we need major surgery, we can have medication in case we aren't prepared for the pain involved in labor, and we can choose to have midwives in the hospital or at home if we prefer that model of care.

Not only do we have choices in our medical provider, but there are countless options to consider when planning your birth.
-Do you want to wear a hospital gown or bring your own clothes?
-Do you want intermittent monitoring of the baby or constant monitoring?
-Do you want an epidural or would you prefer to labor in the shower/tub? (Becoming more popular in hospitals)
-Would you like the baby to room-in with you or go to the nursery?
-If a C-section is necessary, would you like immediate skin-to-skin contact after birth? I was beyond encouraged that Vanderbilt is starting something called "Family-Based Cesarean". Here is the article.

These are just a few options out of hundreds that you, as the parent, can make on behalf of your child and your birthing experience. I think that is wonderful! But these decisions should not be made out of fear or to please family and friends. It is the lack of education that perpetuates the fear that many women have in regard to labor. And I believe no one should come to their decision from a place of ignorance. Birth is a big deal and it belongs to the woman and her partner to decide what is best for their family.

Since this is a blog, not a book, here are the top 5 reasons why we are choosing a home birth:

1. We love the Midwifery model of care.
I love midwives. I love my midwife. I love that in the last 8 months we have developed a relationship beyond just blood pressure and the fetal heartbeat. We talk about our chickens, living in East Nashville, and all the emotions I am experiencing in pregnancy. The midwife model focuses on holistic care, so not just the physical changes the mother is experiencing but also the emotional changes. Our visits are an hour long and often go later. Sometimes I am at her office, other times the appointment is in my living room. It feels comfortable and normal. No receptionist, doctor's office or waiting room.

In general, the midwifery model of care is ideal for healthy moms and babies. But for some women, I wouldn't necessarily suggest a home birth. The decision to give birth at home must come from a place of conviction and education, not out of hype. My midwife and I talked about home births at my 34-week appointment. She was saying that since the documentary The Business of Being Born came out, there has been an increase in interest for home births but not necessarily an increase in good candidates. Even if the mom is young, healthy, and low-risk, she would not make a good candidate if she still views birth as something that is done to her, or something that a medical provider has to tell them how to do. Home-birthers are women who take responsibility for their birth and believe in their bodies to go through labor naturally. The role of the midwife, then, is to observe the birthing process and make changes or intervene when it shifts from normal to abnormal.

Midwifery focuses on the normalcy of pregnancy, and its potential for health. Birth is viewed as a natural process that has profound meaning to many people and should be treated as normal until there is evidence of a problem. The possibility of complications is not allowed to preempt all other values associated with the woman’s experience of bearing and giving birth to a child. Midwives are experts in protecting, supporting, and enhancing the normal physiology of labor, delivery, and breast-feeding (Our Bodies, Ourselves).

I remember leaving my first appointment so concerned because I expected to be probed more, given more tests, shots, x-rays, everything! But it was just a urine sample and my blood pressure. That was it. Michael had to remind me that there was nothing wrong with me, that I am healthy and that the role of our midwife is to monitor this natural process. I had to be really intentional about making that switch in my head. My body was made for this. I am low-risk, very healthy, and I have no family health problems in regard to pregnancy. There was no reason to be concerned. My body knows what to do. I just need to continue to honor the process and my healthy lifestyle.

2. Hospital births could lead to interventions.
We, personally, do not want to intervene in the natural birth process unless medically deemed necessary. I don't want decisions about my labor to be determined by convenience, money, or fear of a lawsuit. I want to be able to relax and let my baby and my body work together in the timing that is natural.

The unfortunate reality is that long labors (especially with first time moms) rarely go uninterrupted. Interventions like Pitocin (synthetic Oxytocin), Cervidil (a prostaglandin to help ripen the cervix), epidurals, constant monitoring, rupturing the membrane, etc. are given to mothers in order to help them progress in a timely manner. The problem with one intervention is that it will likely lead to another intervention, this is called the 'snowball effect' or ‘cascade of interventions’. 

Here is a scenario of this progression:
1. It can start with putting on a hospital gown. Now the mother feels like a patient who must abide by every suggestion given by the doctor or nurses.  
2. Then it may lead to continuous fetal monitoring. This restricts the mother's ability to move around in labor to cope with the contractions. The monitoring is really more for the sake of the hospital to have records than for the benefit of the actual mother in labor. Using a Doppler intermediately would suffice (this would exclude high-risk mothers).
3. Now stuck on the bed, the mother is not progressing because she is not using gravity and movement to her benefit, so she is given Pitocin. Because Pitocin is synthetic, it doesn’t carry all the benefits of Oxytocin. This natural hormone is incredible! It is the same hormone released when we you have a good conversation with friends, give someone a hug or even orgasm - it is called the love hormone. And it is the hormone that stimulates the contractions during childbirth. However, Pitocin does not have the benefit of the love hormone. It creates intense, artificial contractions that do not mirror the natural progression of contractions. They are way more painful because Pitocin does not trigger the brain to release endorphins like Oxytocin. Because of the pain increase, mothers often opt for an epidural. 
4. Although an epidural can really aid a woman who is struggling during birth, it also comes with its downfalls. Epidurals numb the mother from the waist down. This inhibits the stretch receptors from being stimulated, which could lead to tearing. Epidurals can also slow down contractions, which could lead to an increase in Pitocin. 
5. As Pitocin increases, so does the baby's heart rate. Pitocin-induced contractions are way more intense than natural contractions and this increase in intensity could cause the baby to receive less oxygen leading to distress. Once the baby is in distress, a C-section may be necessary to get the baby out quickly. 

This is an extreme situation and not all interventions will end in a C-section. But each intervention does come with its own set of risks and likely leads to more interventions. It is important as the mother to understand the purpose of the interventions and to feel confident to turn them down if it is not necessary. Whether it is a hospital birth or home birth, be informed about all these procedures. You may be totally fine with some of them but not comfortable with others. Make sure your birth partner is on the same page as you so that you can stand united if you feel it is best to turn down an intervention. Trust your instincts! 

3. Midwives are trained in natural birth.
I recognize that for some women these interventions are necessary and I truly am grateful that we have obstetricians to offer medical assistance or perform emergency C-sections for those who need that procedure. However, midwives are experts in natural, normal births and doctors are experts in high-risk, medical births. And quite frankly, if you are someone that is high-risk, a midwife would not take you as a patient and a hospital would be the best place for you. But in a low-risk, normal pregnancy, a hospital is overkill. You aren't sick. Birth, an inherently natural experience, becomes a medical condition the second you walk into the hospital. And with 94% of births in the US considered low-risk, it is likely that additional interventions will not be necessary. 

The biggest misconception about home birth is that it is not safe. What if something happened during birth and you didn't have time to go to the hospital? This is what I hear the most. However, midwives are trained to see when something shifts away from normal. They are trained to recognize a potential issue before it becomes a problem. Midwives know what normal, natural labor looks like. So anything that looks different is a red flag. Quite honestly, many nurses and doctors have never seen a natural childbirth, especially not a home birth. The epidural rate in Nashville is over 90% and the C-section rate is 33% (with some hospitals pushing more like 50%). So unless a machine tells them something is wrong they might not notice the nuanced warnings as they arise. By the way, the World Health Organization recommends that no country exceed 15% for C-section rates. Here is a fascinating article explaining some reasons why Caesarians are on the rise.

My midwife is offering me one-on-one, 24/7 care during labor. I am not part of a rotation, there is not a shift change with the nurses, and there are no other patients to check on. Just me and my body and my baby. Their focus is 100% on me. They come prepared with a midwife assistant, oxygen if needed, a Doppler to listen to the heart rate during labor, Pitocin to help with bleeding if necessary, they are trained in neonatal resuscitation, suturing if tearing happens, they can handle hemorrhaging, and they aren't afraid to transfer to the hospital if further care is needed. I know with my midwife, her transfer rate is 8%. And this is primarily with moms that have labored for so long that they just need a little assistance to get the baby out. I live 8 minutes from Vanderbilt Medical Center if we need that option.

4. I feel comfortable, safe and at peace in my own home.
In my childbirth class we have spent time talking about how to work 'the system' for those planning a natural hospital birth. Our instructor was giving tips for dealing with non-supportive nurses, how to sneak food in, how to say no to certain procedures they routinely perform, how to stay in the shower when nurses prefer for you to be hooked up to the monitor instead, etc. It sounds absolutely daunting! I will be in my most vulnerable state bringing my daughter into this world. The last thing I want to deal with is unnecessary interruptions. I've heard it said that the same environment in which you made the baby is the same in which you should birth the baby. I believe that. It is a very vulnerable, intimate experience. It should occur in a place where you feel safe, where you can let go of your inhibitions, and you can fully relax. I know many moms who have had beautiful hospital experiences with supportive medical providers. So I truly believe it can be done, but for me it would be difficult to do this when doctors, nurses, med students, etc. are coming in and out of the room. Not to mention, you and your partner potentially face 'fighting the system' in order to have the birth you desire. 

When I was 8 I had my appendix taken out. It was absolutely traumatic for me. I was taken to the operating room crying because I had to leave my mom behind. I remember looking around as they moved me from the gurney to the operating table and seeing all the machines and people in the room. When they put the mask on my face with the anesthesia I immediately grabbed it off. I hated it. So they had to hold me down and force the mask on me. I remember screaming and crying into the mask as I went under. I deeply dislike hospitals. Once again, I am grateful that they exist for when I am sick - but I am currently pregnant, there is nothing wrong with me. I do not feel safe in a hospital. I do not feel in control. I feel like all my rights are in the hands of doctors and nurses that don't know me. So for me, my home, surrounded by my family, with a trained midwife that knows me and who believes in my body's ability to birth, that is where I feel safe. 

I am so excited to have the freedom to labor any way I want. I can be in the bath tub, the shower, go for a walk in the park, weed the garden, watch my chickens, bake a birthday cake, sleep, watch TV, eat what sounds good, wear whatever I want... I can do that. I've always envisioned candles at the birth but I guess that is assuming it will be at night…we will see. I like my home. I feel safe in my home and I don't want to have to leave the house. Because my midwife is only 5 minutes away, when I go into early labor I don't have to wonder, "When is the right timing to leave?" I don't want to look at the clock at all. I just want to be. There will be no rushing around, no panic, we will just shift from our daily life into labor and we will take it one moment at a time. When left unaltered, it is pretty incredible what the body will do.

For Nashville mamas - I would also like to add that giving birth with the Vanderbilt Midwives is one alternative for those who don't feel comfortable at home. You get the benefit of the midwifery model of care and the accessibility to medical interventions if that is necessary. I was told that 70% of births with the Vanderbilt Midwives are natural, drug-free births. This would be a great stepping-stone to having your next baby at home.

5. It lines up with our values in life.
When asked recently why we are choosing a natural birth, the answer came quickly for us: we believe that childbirth is a sacred experience that should not be altered or numbed. I mentioned earlier that we view birth as a spiritual moment. Bringing life into this world should not be taken lightly and the way you do it is just as important.

Michael told me shortly after I became pregnant, "How incredible is it that you get to usher Heaven to Earth?" I will be bringing life into this world and I could not feel more honored to be given that task.

Pregnancy has taught me so much about myself. It has allowed me to slow down and take the time to feel all the emotions and changes occurring in my body. I have already bonded with my daughter as I spend time rubbing my belly, watching her wiggle and wondering all about her. I have released fear of all the 'what ifs' and I have kept my googling and “Web-MDing” to a minimum. I have resisted the urge to text my midwife after every strange twinge because I am learning to trust the process and the natural instincts I've been given. I believe that the months of pregnancy are crucial to the moments leading up to becoming a mother. If women will let it, pregnancy can be a beautiful time of refinement and reflection. This whole season leads up to the culmination of birth. It is the ultimate end and beginning.

My heart and passion is that every mom leaves a birthing experience feeling empowered and amazed by the wonders of her body and her ability to bring life into this world. I cited this quote in an early blog post, but I had to post it again:

"Birth is not only about making babies, birth is about making mothers -- strong, competent, capable mothers who trust themselves and know their inner strength" - Barbara Katz Rothman

So I am not saying that every mom should rush for a home birth. I want every pregnant woman to take the time to research all the options out there. And beyond just head knowledge, to know deep down, like gut-level, that their decisions are best for their family. It only just begins with birth. Decisions will have to be made every day on behalf of your family - vaccines, schooling options, dietary options, sleep schedules... the list goes on. Being intentional about your birth is the first step in becoming confident as your new role as a parent. No one should question your convictions. This is between you, your partner and your baby to be.

Final thought:
Of course, I have to make the caveat that when planning a birth, things can change. We should go into it with a plan but remember to hold it loosely if situations change and circumstances require us to deviate from the plan. But isn't this just like everything in life? At least, that's what I am learning ;) Working for a ministry and leading numerous mission trips have taught me a thing or two about flexibility and I am grateful for that!

It is funny that I am writing this post without actually having gone through labor. I don't think my perspective will change on the way I view the process of birth but I know my experience will be part of the story I tell. If I end up in the hospital with a C-section, you better believe I will do all I can to still be part of the decisions, to be active in my labor, and to relish the moment my little girl is laid on my chest for the first time. There will be disappointment to work through if plans change, but the joy we will have from starting our family will outshine all of that.

I can't wait to become a mother.
And I can't wait to share Genevieve's arrival when the time comes.
Happy Birthing!


  1. This is really great. I always thought people who wanted home births were kinda of strange. Who would want all that blood everywhere and, of course, the "is it safe" question. Also, never having seen a birth, I was terrified about how much it would hurt and wanted an epidural. But reading this post has changed my narrow, uninformed opinion. We had our son in a hospital via c-section because he was breech and it was a good experience. We had something akin to the family c-section article you mentioned without asking for it. After reading this, maybe down the road we could try a home birth. It sounds nicer and more natural than being in a hospital. Even though we received excellent care, it was nice to finally go home after the birth with our perfect son. Congratulations on your little girl and thank you for posting your story. I pray everything goes well. Being a mom is the best!

    1. I am so glad you had a great c-section experience! And thank you for being so receptive to this post. My heart is that women who read it will be interested in taking the next step to becoming informed to all their birth options.

      I am very excited to meet my daughter! :)

  2. As a person who is also expecting to give natural birth at home in Nashville, I was very excited to read this! I am also terrified of hospitals and knew it wasn't the right decision for me. When I watched The Business of Being Born a few years ago, I knew home birth was the way to go. My partner is also completely on-board and agreed immediately that we should have a home birth when I asked shortly after conceiving (he is a nurse who has been at several hospital births.) I am not filled with any fear whatsoever surrounding this choice, but there is still fear for much of our family, who have constantly assured me that it is going to hurt and that I will regret not getting an epidural. That is hard sometimes, since unwavering support would be more idyllic. Anyway, thanks for sharing your story!

    1. It can be challenging when you don't have the support of family or friends but it is great to hear that your husband fully supports you - that's who really matters! Praying you have the beautiful birth you desire!

  3. Hello there, I have been following your blog for some time and I just have to say I am so inspired by your organic lifestyle. It is everything I dream of! Simple and sweet and natural. I pray your birth story will bring much glory to the Lord!

    1. Thank you! I know that however Genevieve chooses to arrive will be such a holy moment!

  4. Kudos to you both for being informed decision makers! While I had a hospital birth with minimal interventions, I've attended a home birth and experienced the beauty of it. Just as I'm sure you already know, there are numerous options for everything with birth and raising children, and you have to pick the one that's right for you. My son's birth was right for us, and Genevieve's birth will be right for your family. Also, this is a beautiful explanation of the reasons for a natural birth! Well done!!

    Nikki Poarch

  5. I have just found your blog but I am already in love, especially with this post! You've said everything I have thought on the subject. Good job, Mama! Wishing you a healthy birth!

  6. I love this! you are definitely educated and know what you're doing. so glad you have the ability to do this at home. i can't wait to hear about your experience