A shining example of a healthy homebirthed baby: six hours old.

We’ve been feeling a little under the weather around here and I’ve been indulging in a little daytime television…I think I’ve had it with that pastime after seeing The Dr’s on CBS yesterday afternoon. I was interested in the topic presented regarding a couple’s decision about where to birth their first child. I had high hopes for a well thought out discussion because there happens to be a Dr. Sears on the show’s panel of doctors (that would be the son of the Dr. Sears).

Apparently the doctors had absolutely no intention of helping these poor folks make a well-informed, thoughtful decision because the entire segment seemed to be geared toward inspiring fear and intimidation about what is a very normal and healthy process. Dr. Sears was not even invited to the discussion even though he was in support of home births (four of his siblings were born at home). Instead the “expert” OB climbed up onto her soap box and announced that home births should be banned in this country due to the extreme risk that they pose. Personally I hold the conviction that defensive medicine should be banned and this lady should pack up her doctor bag and take a hike. I was particularly alarmed when after scaring the poor mother-to-be with stories of babies getting stuck in the birth canal she listed “pushing the baby back in” as one of the appropriate medical procedures used to resolve the situation.

Now folks, if you have a doctor that tells you that it’s ok to push the baby back in then you had better run–not walk–out of their office immediately. This is known as the Zavanelli Maneuver and one of the most dangerous applications that a doctor could perform during birth. It puts mother and baby at extreme risk and was actually made popular by the television show ER. Yep, ER. If you find that your OB is taking pointers from a television show then I would strongly advise you to seek another birth attendant. Fast. A more appropriate method of dislodging the baby would be to use the Gaskin Maneuver, so named after the queen midwife of them all, Ina May Gaskin. It basically entails moving the mother onto all fours–the motion will more than likely get everything back on the right track. It is commonly used by both midwives and physicians alike and has proven to be extremely effective. There are a few more tricks that midwives commonly use to dislodge a stuck baby but if he just won’t move then you have an emergency on your hands and it’s time to transport to the hospital for a cesarean section.

Don’t get me wrong–I support the incredible opportunities that modern medicine gives me as a patient. If I ever need a heart transplant or something then I will humbly do as my doctor orders. I just don’t think that medical procedures need to be such a “routine” part of giving birth. Physicians have lost touch with the ability of the human body to take care of itself. The impending need to control the situation apparently rears its ugly head even in the face of the most humbling and miraculous event around.

When I was pregnant with our son, we did a lot of homework about our choices. A LOT. I thought people who had home births were nuts! Little did I know that only a few short months later I would be delivering a bona fide human being right smack dab in the middle of our very own bed in our very own home. Initially, we decided that a family physician would be the road that would suit us best.

Then we presented our birth plan.

When the doctor raised an eyebrow at a few key issues and then informed us that the birth plan was “really for you guys–it doesn’t really have much to do with me or the staff” we knew that we were barking up the wrong tree and it was time to make some major decisions. We switched to a very qualified and trustworthy certified midwife who not only inspired the confidence within us to participate in a natural birth, she completely opened my eyes to the gross inadequacies that women face in their health care needs. The sad part is that we don’t even have a clue about how bad the system has become. It’s kind of like telling a fish that has lived in dirty water all of its life about what a clean environment feels like. Want proof? Switch your annual well-woman exam over to the care of a midwife that you admire and respect. It’s a whole different world. No stirrups, no crazy instruments, no freaky paper dress–can it be for real? Yep. And you don’t leave the office with that weird violated feeling either.

I digress. Below are some of the key issues and questions that we considered when making the switch from a physician to a midwife. These questions are the specific issues that we were personally concerned about with our son’s birth and were the major “make it or break it” issues.

Questions for the Doctor

• What is your cesarean rate? (Anything above 10% is considered high in most developed countries. They typical rate in the US is around 20-30%.)
• Do you perform episiotomies? (It’s to your benefit to tear if necessary but a doctor who doesn’t perform this procedure is more likely to help stretch your perineum to allow room for the head and shoulders.)
• What situations do you consider emergencies? (At what point are you going to want to perform “routine” procedures like vacuuming the kid out of me?)
• How long do you feel comfortable letting a woman labor without medication? (This is a good way to gauge how much experience your doctor has with natural childbirth.)
• Have you ever attended a home birth directed by a certified midwife? How many? (Good luck.)
• What are your thoughts about natural childbirth?
• What are your thoughts about alternative medicine?
• Are you comfortable working with a doula? (This question was helpful for us to “read” how in control a doctor needed to be.)

Questions for the Midwife:

• What education and training did you undergo to become a midwife? (Typically about 8 years of education and hands on training.)
• How many births have you attended?
• What is your cesarean rate? (Our midwife’s is 3%.)
• What percentage of births that you have attended have been transferred to the hospital?
• What constitutes an emergency to you?
• What kind of emergency training do you have?
• Bring examples of situations that you are worried about for specific answers, such as a “stuck” baby.
• What kind of rapport do you have with the hospital staff?
• Is it possible for you to direct our birth at the hospital? (This is an ideal situation in my opinion but is not permissible in some cities. Like ours.)
• How long will it take us to get to the hospital? (For us the answer is 10 minutes. If it were to take longer that 20 minutes I think it would greatly affect our decision to choose a home birth.)

The key is to educate yourself about your body and your pregnancy. We delivered a healthy baby boy after 26 hours of labor (four hours of pushing): 8 lbs, 14oz; 21 inches long; 15 1/2 cm head circumference.

Home birth was the way to go for us–it was a peaceful and fulfilling experience and I am grateful that I was able to go on such a personal journey with my body, my husband, and the screaming little tyrant that we brought into the world together one year ago this Tuesday.