The homebirth craze that’s sweeping the nation

So, you may have gathered from Seth’s “I got my girlfriend pregnant!” post that I am going to have a baby.

(PS, wouldn’t it be super-awkward if the whole time I thought he was talking about me, but then it turned out that he had actually gotten some other girl pregnant, in addition?)

When the baby decides to show up, I would like to have a homebirth. Here are some of my reasons:

I was raised by hippies, and then in Holland (which is basically a nation of hippies who grew up and got steady jobs.), I was born at home, my little brother was born at home, I feel fairly informed on the topic of birth and just don’t think that super-medicalized hospital births are necessary for people having low-risk pregnancies.

Also I get a really specific variant of Feminist Outrage about how people kind of get all controlling about women’s bodies, particularly when they’re With Child (“Did you see that woman drinking coffee?!?”)

And when I think about having to go to a hospital and arguing with someone who has donned the mantle of medical authority about how I do not in fact want a pitocin drip “just to help things get going”, and if I need an IV line they can put one in when I need it, not when I first walk in, etc etc… I get all fretful. In a way where I just know that I would not be discussing this crap calmly and rationally but instead in tearful tones that probably culminate in me choking back a sob and saying YOU’RE NOT THE BOSS OF ME!!! I AM OUT OF THIS DUMP! SCREW YOU PEOPLE! and waddling out in my socks and hospital gown.

…which would be so uncool!

Seth (who was not raised by hippies in Holland) and I have had some arguments about homebirth vs. hospital birth.

ELANA’S PERSPECTIVE:
I get that if I have a baby at home there isn’t an ER standing by next door for an emergency C-section, so there’s a certain amount of risk present that isn’t present in a hospital. I acknowledge that slight risk increase and will do everything I can to minimize it, but I am willing to accept the remainder. Because I believe the risk of maternal and fetal death in birth to be overstated by a culture that’s terrified of natural physical processes: the majority of low-risk pregnancies are healthy, the majority of low-risk births go just fine. And it’s not like I’m going to be having a baby by myself in a clearing in the woods and having the cord chewed off by bears, we are actually hiring a nurse with advanced training in midwifery. Etc.

SETH’S PERSPECTIVE:
Things go wrong during childbirth.

ELANA’S PERSPECTIVE:
Well, yes, sometimes.

SETH’S PERSPECTIVE:
I like you. I don’t want you to die. I think I will probably like the baby as well, and, you know–

ELANA’S PERSPECTIVE:
Nobody’s going to die!

SETH’S PERSPECTIVE:
Can you guarantee this?

ELANA’S PERSPECTIVE:
…well, no–

SETH’S PERSPECTIVE:
You know how I’m a man? You know what men like and feel comforted by? Gadgetry. You know where they have a lot of that?

ELANA’S PERSPECTIVE:
Hospitals?

Like many excellent husbands* Seth has some of that male fix-it personality thing happening where part of how he feels like he’s taking good care of his family is by controlling for risk factors. So we periodically have arguments about this stuff. It’s okay- we struggle through it. Seth has kindly agreed that we will start prenatal care with a midwifery practice, I have agreed that we will tour the labor and delivery ward of the hospital our insurance covers**. So it’s not like anyone is making outrageous demands or throwing out ultimatums here or anything. But it’s weird to try to be balancing the needs of three people at once: my need to have a pregnancy and birth where I don’t get treated like my body is a lemon, a ticking bomb that could just GO OFF AT ANY TIME JUST LIKE THAT NO WARNING; Seth’s need to make sure that his wife and child are as safe as they can reasonably be; and of course the Lentil’s need to, you know, not be born addicted to crack…

JUST KIDDING! I quit the hard stuff as soon as I found out I was pregnant.

JUST KIDDING.

To briefly circle back to the area this blog apparently purports to cover, what was super-weird to me as we were figuring this stuff out is the price difference between an uncomplicated hospital birth and an uncomplicated homebirth: in our area, an uncomplicated vaginal birth in a hospital would run you around ten thousand dollars. The hospital that our insurance covers, however, only has about a 70% rate of those uncomplicated vaginal births (which is actually very good, by regional standards), so quite a lot of the rest are running into the multiple tens-of-thousands.

The midwife practice we’ve hired (for which we will, we hope, be reimbursed at some semi-lame level by the same insurance company that would basically cover a 10k hospital birth soup to nuts) does all of your prenatal care, the birth, and a series of post-partum visits for just under four thousand dollars. It’s a practice run by a certified nurse midwife, and their rate of “transfers” (births that don’t progress at home and end up in the hospital) is about 10%. Their rate of C-sections is less than half that.

So I just don’t understand why, as an insurance company looking to cut costs and maximize profit, you wouldn’t think “Hmmm…. 10k for JUST a birth or 4k for all prenatal care and a birth, PLUS you get a much lower number of spendy complications… let’s switch to a system where we encourage low-risk moms to deliver in a birth center or at home with a midwife, and save our expensive OB-GYN-led hospital births for those who would otherwise be at risk. THINK OF THE SAVINGS. THINK OF HOW MUCH MORE MONEY WE’D GET TO STUFF IN OUR GREEDY INSURANCE POCKETS!!!”

But instead, you get these weird things where insurance companies are happy to cover almost the entirety of a high-intervention, super-expensive hospital birth, and getting a home- or birthcenter birth (or even, for some people, a midwife-led hospital birth) covered is a loser of an errand. Which again, makes no sense to me. Why wouldn’t you take the six thousand dollar price break per mom and pat yourself on the back?

(But of course it’s semi-ridiculous of me to expect American health care to have any resemblance to a system designed by people who are not morons.)

***

One thing that is weird about homebirth is that I am actually not as far-left as I think homebirth people in this country are usually assumed to be. To me, homebirth is cool because I think that birth is a pretty normal biological process and that a lot of hospital processes can actually lower your chances of a healthy vaginal birth, and thus a good outcome for mother and baby. Also because I am extremely modest and the idea of men I don’t know looking up my cooter in a hospital is THE WORST. That kind of stuff.

But a lot of people who are into homebirth here are also into things like not vaccinating, taking pictures of their vagina as the baby crowns and posting them on the internet, being convinced that there is a conspiracy to keep the truth about autism and circumcision and tofu*** from the public… etc.

I AM NOT THAT PERSON.

When Seth and I were interviewing midwives, I kept finding it kind of hilarious when the midwives would be all “We can refer you to some really great pediatricians who don’t force you to give your babies evil poisonous vaccines”, when I am the kind of girl who thinks that vaccines are SUPER GREAT, basically THE BEST, right up there with the development of antibiotics and communal sewer systems. So I would say something like “Well, I think we’ll probably be getting all the vaccines there are.” and the midwives would pause and then struggle for non-judgment and serenely say something like “Well, your baby is choosing you to be its parents for a reason.” as they listened to the wind chimes and tiny indoor fountain make calming noises in the background.

So for me, aside from the fact that insurance companies are LAME-Os, the only downside to homebirth is that I kind of have to balance my desire to not go to a hospital and be treated like a sick person with my almost equally as strong desire not to be told nonsensical unproven things about “herbs” or about how eating peanut butter while you’re pregnant will give your baby asthma. We will have to see how it goes.

***

Here is part of a letter I wrote to my mother and mother-in-law, updating them on our first big prenatal appointment:

Seth and I had our first big prenatal appointment today. The midwife kept declaring that I was “Extremely healthy!” and that the baby was “Exactly the right size!” (…?!? I don’t know… I didn’t realize there was concern that fetuses would be drastically outsize or anything.) Also the midwife said “Seth! Come over here! Feel your baby!” and Seth politely poked my lower abdomen and said “…yes, fantastic.”

But we also heard the heartbeat again, which still sounds like a German techno song. And while the midwife was listening to that there was a sound “Like Saran wrap being scrunched”, according to the husband, which apparently is the baby moving around. Again, ???.

At some point this week we have to call the backup OB-GYN to go in and see them, where they’ll do an ultrasound to make sure the baby doesn’t have three or more heads. Also I will have to go back to the midwives next week to review my diet. Seth and I had just been having smug conversations about how our family diet is really quite good, and involves little in the way of prepared foods and junk food, and lots of fresh whole foods and delicious vegetables. But man, were we WRONG ABOUT THAT. Apparently.

The diet suggested by our midwife was so extremely bleak (“and then for lunch you could have a small salad with maybe a few beans thrown in.”) that Seth reported having Diet Advice Backlash when he got to work, eventually becoming so obsessed with the forbidden (candy) that he ate half a box of Mike and Ikes and then regretted it. I had a similar backlash, leading me to have some chocolate ice cream. PROBABLY DAMAGING THE LENTIL**** FOREVER AND LEADING TO SEVERE BRAIN TRAUMA.

I was also sternly admonished to avoid peanut butter, as it allegedly leads to an increase in rates of asthma in babies. But luckily Seth is a skeptical science-minded guy, so as soon as we left he was all “Okay. One thing. What was the deal with the peanut butter? That sounded like hokum.” so we went home and looked it up, and indeed, evidence is sketchy and inconclusive and there was only an increased rate of asthma in the children of mothers who ate nuts every day. So I’m going to be a scofflaw and occasionally have some delicious peanut butter. (Although I will probably claim to the hippie midwives that I’m only eating almond butter, as directed. So as to avoid conflict.)

Other things that happened:

*The moment where the midwife said “You have excellent nipples for breastfeeding!”.
*The moment where the midwife, who had her fingers UP MY PRIVATES, said “Excellent, your cervix is long and closed” and my husband later felt the need to ask what that meant, even though my head was about to explode.
*The moment where the midwife, for unclear reasons, told me to, uh, perk up my excellent-for-breastfeeding nipples, and said “See how they just stand up like that?”

I feel like pregnancy is one long festival of embarrassment. Designed, probably, to lower your resistance to shame and embarrassment to zero so that later when your baby poops all over your sweater you’re more like “Sigh” and less like “OH MY GOD I AM COVERED IN SOMEONE ELSE’S EXCREMENT, THIS IS THE WORST THING THAT HAS EVER HAPPENED TO ME.”

*I’m guessing… he’s my only one so far. But this is what I gather.
**Well, WILL cover. Someday. Maybe.
***Tofu, apparently, is TERRIBLE. And will KILL YOU.
****This is what we call The Unborn. Because at some point it was that size, and also because it’s less creepy than calling it “The Fetus”.

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9 responses to “The homebirth craze that’s sweeping the nation

  1. There are so many women who feel the way you do, about not technologizing the birth process unnecessarily, while also not wanting to have to chant with whale songs during the delivery. I chose midwives for my 2nd and 3rd kids and it worked out great, even in the uninspiring setting of the MacDill AFB L&D ward. But maternity care has come a long way in this century, and I’m really hoping you are pleasantly surprised by your L&D visit.
    And hey, just because my parents aren’t Dutch hippies, doesn’t mean they didn’t put millet in our oatmeal and feed us probiotics in 1974 and ban the Brady Bunch from our TV. Not that we got to watch TV…..

  2. This is Seth’s friend Chris, and I am so psyched for you guys.

    I also relate to your post. My wife and I tried for a natural childbirth at the hospital, and we took a course on hypnobirthing. We also hired a dula, which was the best decision we made – during the birth, the doctor was there five minutes; nurses were in and out; but the dulas were stuck there for the duration, and they could give us commonsense feedback and advice and basically hang around and know what was going on. (Of course if you have a midwife, it sounds like that’s the same deal.)

    But it was tricky to find the right people and the right level of … what would you call it, naturalness? We were pigeonholed once by a nurse who thought that breastfeeding is the ONLY WAY – not very controversial, and that’s what we were planning to do, but it’s like, “Woah, okay, stop spitting in my mouth when you talk to me about this.” For us, they key was to find a dula who was psyched to go natural but wouldn’t act huffy if we needed to start in with the drugs. And ultimately, we had a c-section, so you know – you go in with your birth plan, and then what happens happens.

    Can’t wait to read more. Congratulations!!!

    • thehandsomecamel

      Hey man!

      Thanks so much — we’re stoked. Yeah, I think if we end up in a hospital a doula would totally be a worthwhile choice. Kind of an impartial advisor — someone who’s a little less likely than the dad to freak out at the first sign of something weird. I sort of imagine a doula for dads would be good, actually — somebody like R. Lee Ermey who stands in the corner and smokes a cigar and goes, “No, it’s fine. Don’t freakin’ worry about it.”

  3. Wouldn’t the midwife go with you to the hospital? Or are they not allowed to deliver in hospitals in CA. I mean, Katie had midwife births in Northside in Atlanta, way back when.

    • thehandsomecamel

      @ Cher —

      Well, that’s the interesting thing — the midwives would go to the hospital with us, but they wouldn’t have admitting or delivery privileges at the hospital, so we would be transferred to the care of another midwife or an OB. More probably the latter, since if we were to transport it would probably be because something unusual/undesirable was happening.

      Personally, I think it would be ideal if nurse-midwives could transition with you into the hospital setting and continue to care for you, working in concert with an OB. But the way it works, at least as far as I can tell, is that you select a “backup” OB who agrees to meet you at the hospital if needed, and with whom you have an appointment or two beforehand, so he/she isn’t a stranger to you.

      Unless there’s a true emergency, of course, in which case you go to the emergency room of whatever hospital is closest.

  4. And there is nothing wrong with millet in the oatmeal and probiotics. Look how tall you both are.

    • thehandsomecamel

      I agree. Nothing wrong with the millet in the oatmeal. There are times, however, when I mourn the years I wasted not eating chocolate. Usually a Ritter Sport bar will bring that mourning to a fairly tidy end, though.

  5. OMG I love to hear the nitty gritty about pregnancy and birth. This blog will be checked by me constantly. As you know, My son was born in rural Japan 24yrs ago and at that time it was similar care to 1950s America with Dad in the bar and the mom laboring away without meds, while the doctor smoked and looked at the chart ocassionaly. Two years later in Australia my daughter was born. The midwives in the hospital took care of me from start to finish and their first question was ; “So, how do you want to have this baby? Standing, lying, birth chair or under water?” Whoo, from being tied to a gurney with Bobby to carefree and happy with Marie. I’m sure you and Seth will get the best combination of techno care and loving, compassionate care. And as long as there are no red flags during during your last trimester, then, hey stay at home and be comfortable. I am so happy to see you lampooning those uber earth moms.
    Love,
    Jenny

  6. Pingback: in the blink of an eye it can all go awry « Fighting Commies For Health Insurance!

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