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my niece, Sophia |
Never having
given birth myself, I hadn’t considered how many factors there are when
deciding where to give birth. Doesn’t
everyone just give birth in a hospital? That may be the perception of many
Americans considering close to 100% of U.S. births take place in a controlled
and/or clinical setting.
When my
Grandmama was born in 1932, there was no question that she would be born at
home. When I spoke with her tonight, I asked her if she considered giving birth
to my mom (in 1956) at her home. Grandmama chuckled and said “No way.” My mom
gave birth to me (in 1985) at Methodist Hospital in Rochester, MN.
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March 10, 1985 |
I only know of three women who have given birth at home. I
asked my friend, Abby, about her experiences giving birth to her now 18-month-old daughter.
Abby hadn’t thought much about where she would give birth until she spoke with two of her friends who had both done home births. Abby
wanted to know more about it and began asking them questions and doing some
research. Abby and her husband, Aaron, had their initial appointment at a
doctor’s office. Right away, they felt as though the doctor had no time for
them.
The
following day, Abby and Aaron met with Marcy, a licensed midwife. Marcy spent an
hour with them asking them what their ideal birth would be like and encouraged
them to think through what they did and didn’t want. Abby and Aaron decided
that having Marcy be with them through the entire pregnancy was the best
decision for them.
Abby listed
some of the reasons why she chose a home birth over a hospital birth. She
wanted:
- to
be in a peaceful place where she felt calm. At her home Abby was able to move from room
to room, go up and down stairs, lay in a bed, take a shower etc. Abby’s dog,
Bauer, was also there to comfort her.
- to
be the one to make decisions about her body. Abby liked that she could eat if
she was hungry and move when or where she wanted to. She also liked that no one
would be poking and prodding her throughout labor.
- no
one coming in and out as they pleased. At the start of labor, Aaron texted
family to say “Abby is in labor” He then turned off their phones for the next
20 hours. There were no outside distractions.
- to
give birth naturally, the way God designed our bodies to do. Abby knew she didn’t
want to have an epidural or be hooked up to monitors.
- someone
to be with them every step of the way. Marcy met with them numerous times
before and after delivery. When Abby was in labor, Marcy was with them from
8:30 a.m. until 4 a.m. the following morning.
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Abby, Aaron and baby Hazel |
I asked Abby
what it was like telling her family she was going to have a home birth. She
responded:
“It was
hard. People had lots of questions especially our moms. My mom was silent and
didn’t say anything to me about it for a long time. Aaron’s mom had lots of
questions. After Hazel’s birth they said several times, 'We were so worried!' I
felt bad because I don’t like when people are upset.”
Abby is now pregnant
with her second child and is looking forward to giving birth at home again.
My older
sister, Sarah, is a nurse at Mayo Clinic in Rochester. Sarah gave birth to my
niece, Sophia, at the hospital in 2004. While I wasn’t there for the birth, I
did get to come to the hospital right after Sophia was born.
 |
meeting my niece for the first time |
I recently asked my sister why she choose to
give birth in a hospital. She responded,
“It’s a piece of mind knowing you’re going to give birth in a hospital. You
know you have care right there. If there’s a problem, everything you need is
there.”
Before
giving birth, Sarah didn’t feel strongly one way or the other about getting an
epidural. However, 18 hours into labor, she was given one. “Personally, I loved
the epidural,” she said. She went on to explain that she was a completely
different person before and after the epidural. “It was terrible. I was in such
pain. It was so awful. After the epidural, I was kind and relaxed.” Sarah said that if she were to ever give birth again she would choose to be back at the hospital
because of the epidural.
So what’s
going on outside of the United States? When compared to the U.S., planned home
births are much more common in other developed countries. I had the opportunity
to speak with an expert on this topic.
Rachael Kulick
is another one of the few women I know who has had a home birth. Her delightful
son was one of my former students. Rachael has almost completed her PhD from
the University of Minnesota. Her dissertation compares home births in the U.S.
to home births in the Netherlands.
While in graduate
school, Rachael became a certified doula. She did massage during labor and
prenatally helped women decide what kind of birth they wanted. When I asked her
about her experiences, she said, “I was so disappointed in what I was
seeing in Minneapolis hospitals, so I just started thinking there has to be an
example of someplace where they do it better. I wanted to find a maternity care
system that I thought worked better.” Rachael came across the example of
the Netherlands, where 30% of babies are born at home.
Rachael was
heavily influenced by a few books she read about home births. These included “Labor
Pains” by D. Sullivan and R. Weitz. She especially enjoyed “A Pleasing Birth”
by R. De Vries. Rachael even had the opportunity to meet De Vries. He was the
one who initially invited her to visit the Netherlands.
Rachael
spent the next few years studying Dutch, making connections, and traveling between
the Netherlands and the United States. As she conducted her research, she
worked closely with women and their midwives in both the U.S. (Duluth and the
Minneapolis area) and in the Netherlands. Rachael did prenatal interviews with each
woman in her study and attended the prenatal appointments. Rachael was also there
for the births and the postpartum visits. A number of weeks after the baby was
born, Rachael did a final interview listening to each woman’s birth story from
their perspective. Rachael found that every woman in her study wanted to have
another home birth for the next child.
The
following are some reasons why the Netherlands teach home birth when other
developed countries do not…
- the
Dutch developed the concept of the nuclear family (parents and biological
children) before other countries in Europe. They started living in single
family homes before other societies did.
- midwives
were trained really early on – 100 years before they were trained anywhere
else. Midwives have a lot of power in the Netherlands. In the U.S., midwives got
pushed out of practice by physicians.
- the
Dutch people are relatively wealthy. Homes are clean and well lit; very
pleasant places to give birth.
Unfortunately,
there has not been very much data collected regarding home births in the United
States. It wasn’t until the 1990s that the National Center for Health
Statistics began even collecting data. One of the problems of having such little
data about home births is that people tend to share all sorts of opinions about
the dangers of giving birth at home even though there is no research that supports that belief. It is important
for research to continue in this area to help fill the knowledge gap.
Now that
Rachael is practically finished with her PhD (she defends her dissertation in
December), she has some big decisions to make about where to go from here. One
thing she mentioned she’d like to do is start a home birth research
organization. I’m sure my friend, Abby, would’ve loved to have an organization
like that when doing her own research about home births.
Rachael has learned that women in the U.S. are commonly told that giving birth at home is irresponsible and is putting their baby's life at risk. In the Netherlands, women are treated like normal human beings when they choose a home birth. Rachael hopes that eventually women in the U.S. could plan a home birth without being judged or viewed negatively.
If you'd like to read Rachael Kulick's dissertation it will be available on Proquest sometime after February 2014. For more information, you can e-mail Rachael at kuli0015@umn.edu.
I forgot to
mention one thing. In one of my readings for this week, it said that in the
Netherlands, they have special ambulances called “flying storks” that speed
mothers and their newborns to a hospital if needed. Crazy! Dutch research shows
that home births can be better for mothers and are no worse for infants than
hospital births.
So there you
have it. Home births vs. hospital births in a nutshell. Which will you choose? Why
do you prefer one or the other?