I hope this doesn't turn into "I disagree with my partner" week around here, but here's number two. Katie writes:
"I'm hoping you and the readers can shed a little commonsense light on my current *drama*.
I'm 20-ish weeks pregnant with my 2nd child. With my first, I had planned to go natural all the way, but at a hospital; I ended up with an epidural and pitocin. I had really looked forward to trying a home birth with my second. However, my husband is completely opposed to this idea.
He knows the statistics, he respects my desires, and it's not like he's "put his foot down" or anything medieval like that. But over the course of several conversations it's become clear that what he wants (all possible medical options readily available for mother and child) is not going to change. He's all for natural birth, it just has to be at a hospital for him to feel safe. I have extremely ambivalent reactions to this. On the one hand, I am all "womyn power" and wondering what the hell right he has to tell me how to do something that a man has actually never once done -- and what if this is my last child, my last chance to maybe have a birth go maybe sorta kinda the way I want it to? On the other hand, this is his child too, and the lives of two people he loves very dearly are at stake in what can be a pretty dangerous endeavor, and it's not unreasonable for him to want to protect us by having doctors ready and waiting.
I have a feeling we're going to end up with a classic compromise, where nobody involved is happy. I am truly, physically afraid of being in the hospital again, and my biggest fear is that even if we stay home until labor is pretty far along, once we get to the hospital my labor will stop because I am so freaked out, and then it's drugs and numb legs again. But I just don't think a home birth is possible without a partner who is in it a hundred percent. If any of your readers have had a similar situation between two stubborn spouses, I'd love to hear how things turned out."
It would solve everything if there's a true birth center in your area. Then you could have a birth that doesn't terrify you, and he could have a birth that doesn't terrify him.
Because that's what this really boils down to. You are terrified of being in the hospital, afraid of what's going to happen to your body and your autonomy and your child. He's terrified of not being in the hospital, afraid of what could happen to you or your child. And no matter how many stats you can show him (that planned homebirth is at least as safe if not safer for mother and baby than hospital birth, especially for a second baby) he's not going to lose that fear. No matter how many stats you can find about successful outcomes for second babies (and believe me, the second baby is ridiculously easier for almost every woman I've encountered) you're not just going to be able to lose your fear of the hospital.
Now I know there are some of you out there thinking, "What does she have to worry about? All she had was an epidural and pitocin. It's not like she had a c-section/huge episiotomy/horrific induction/preemie in the NICU/etc." Some of you probably deliberately asked for the epi and pit, and really don't get what Katie's worried about.
But this isn't misery poker. If you've read my first post on preventing PPD, you'll know that I think a Good Birth is so important for a mother. And you'll also remember my definition of a Good Birth: A Good birth is one in which you're respected as a person. So the actual details of what happened to Katie during her first birth aren't vital. What matters is that she didn't feel respected throughout the process. It sounds like she felt victimized, and she's really scared that she's just going to end up being shoved into the sausage factory again for this second birth.
Katie, I agree that it sounds like you can't really have a home birth, because it's just going to be too frightening to your husband. It's really, really a shame that you don't have a freestanding birth center near you, because that would absolutely bridge the gap for you and your husband. But since there isn't one and you're probably going to have to have the baby in a hospital, your focus should be on creating a team that will respect you during the entire process of the labor and delivery.
The crucial components you need to look for are:
1. A hospital with good stats for birth without interventions. One of my friends was the only person any of the nurses working that night had ever seen give birth without an epidural. In hindsight, she says she would have picked a different hospital. She knew she could do it, but the nurses were so out of their element without the epidural that they really had no idea how to support her. Birth is really not something you want to be a pioneer in, if you can help it, so find the hospital in your area that has the lowest rates of epidurals and pitocin use. (Since you're a second-timer I wouldn't really worry about c-section rates. Once you've had one vaginal birth your chance of having a c-section is teeny unless something really goes wrong, in which case you'd be happy the technology for the c-section existed.) By the same token, if you know you're going to have a c-section, you want to choose the hospital that does a ton of them, so it's standard procedure for them.
2. A doctor or midwife who really gets what you want and why you want it, and wants that for you, too. A provider who understands why you want an unmedicated birth (and isn't patronizing about it) is going to respect you and your wishes, and use that to help make decisions if things don't go according to plan. (Flip that around to "medicated birth" if that's what you want.) There's no guarantee that you'll have the birth you want, but having a provider who really is on your side means you'll come out of it feeling respected and like everyone did the absolute best they could, including you.
3. A doula. IMO it's absolutely worth it to pay someone to be with you from start to finish and provide a protective layer between the hospital bureaucracy and you. It's just too much of a risk to go into the hospital and take your chances with the nurses on duty if you're feeling that much fear, since the nurses make the whole experience unless you have someone else there advocating and translating for you. It works out if you have a great nurse, but if you have an inept nurse or a distracted nurse or a nurse who thinks the kind of birth you want is ridiculous or a nurse who's just a mean person, you get hung out to dry. Better to bring your own support person who's been at bunches of births and knows how to help you navigate the whole experience. You will probably get lucky, and the doula will spend most of the time helping you through contractions for a few very intense hours until your baby pops out easily with no tears.
So, yeah, this didn't turn into much about how to settle a marital dispute. I lucked out myself, because my own first birth (starting at a birth center and ending up at a hospital) was such an indictment of hospital birth that my husband was convinced easily to do a home birth. (It probably helped that during the interview, one of my midwives looked him straight in the eye and said coolly, "We don't play. If something happens we go to the hospital instantly.") I was happy with my home birth, but then pretty much every woman I know was happy with her second birth, especially compared to the first one, no matter where or how she had it.
Give me what you've got about this. Did any of you have a similar dispute? How did you resolve it?
Also, if anyone knows a good midwife and/or doula who works at Englewood Hospital in Englewood, NJ, will you email me to let me know? It's for a friend. Thanks.
I'm back with another thought, which may be too pop-psychology-sounding for you, so do with it what you will. Part of the work of preparing for a homebirth in this culture is confronting the very small chance that a catastrophe will happen. It might be a catastrophe that a hospital could have averted, or it might be an inevitable catastrophe, but in either case a couple will have to deal with fallout from people saying, perhaps smugly, "That's why I'd *never* have a baby at home."
When you say he's stubborn, that makes me wonder if you're letting him do that work right now so that the two of you are polarized and stuck, with you saying "homebirth can be so amazing" and him saying "sometimes bad things happen at homebirths." (This comes right out of Harriet Lerner's books, which I have found extremely helpful in my own marriage to a stubborn man.) If you take a step in his direction -- which could be as simple as saying, "you know, I wonder what happens when couples plan a homebirth and they need to transfer to the hospital at rush hour..." -- you may open up a space for him to move back toward the middle.
This sounds simplistic, but I've been amazed at how much it can help. Best of luck to you!
Posted by: CJ | August 21, 2007 at 11:30 PM
I had a wonderful hospital/birth center unmedicated birth and it was due, in large part, to the nurse on duty that night. I actually had three nurses, but the main one through the long haul was incredible. Very experienced; very no-nonsense. She assured my husband that he could help. And showed him how he could help. She advocated my birth plan to the OB. If she hadn't been there on my side, I'm not sure how things would have gone. I'm definitely hiring a doula for our next birth - just so I have someone like her there for me.
Posted by: erika | August 22, 2007 at 07:56 AM
Just about everything that can be said has been said, but I'd like to offer this:
Just because it's called a "birth center", it doesn't mean it is a birth center.
The hospital where I had my daughter called their baby-birthin' wing The So-and-So Birthing Center. It had a hotel looking room for labor and delivery and some amenities. It smacked of 'respect' and 'good birth', but the reality was opposite that, as we learned in the birthing center tour.
The rooms and wing can look great, and maybe they offer birthing balls and hot showers, but it's the policies that matter. Policies like only letting you labor for 24 hours before recommending c-section, requiring you to get an IV and a monitor upon arrival, and requiring you to stay horizontal in bed (no standing - you could slip and fall!) once you're on the monitor.
The policies are what you need to know about a place - the name won't tell you that. And if anyone is in SE Michigan and wants to know what hospital I'm talking about (because you would like that or not), email me.
Posted by: amy | August 22, 2007 at 08:40 AM
I haven't read all of the comments so please excuse me for repeating what has already been said....but I was pretty much in the same situation. Except that not only was my husband not comfortable with home birth...I didn't have a comfortable place to homebirth as our house is currently under pretty major renovations that won't be complete until after the baby is born so it really wasn't an option anyway. hanging out in my dingy tub and birthing in my bedroom with plaster peeling from the giant hole in the wall didn't sound too appealing. There is a free standing birth center in my neighborhood but the hospital they do transfers to is not someplace I would be comfortable birthing. I would rather start out in a hospital of my choosing than end up transferred to one I'm not comfortable with.
I met with several providers before deciding on a team of midwives at a natural birth friendly hospital. It isn't ideal, it is further from home than I would like and doesn't let you use the tub after your membranes rupture (they do let you eat and drink what you want, move around, don't hook you up to monitors or IVs unless medically indicated and have a 50% epidural rate so the nurses are very used to supporting unmedicated moms).
From my interviewing experience, look for midwives or a family doctor to be your provider. With very few exceptions OBs just aren't the best choice if you want to go natural. I wasn't able to find an OB who truly supported natural labor. I do know they exist, I just cound't find one that took my insurance. One told me he was happy to "let" me labor naturally. Another told me he worked with lots of women who wanted to go natural but they almost all chose an epidural (gee, could it be your 80%+ induction rate that contributest to that?)
I met with 2 family doctors who did deliveries and they were both wonderful and very supportive of natural evidence based medicine. One, who was a bit older and had practiced for severl years in Latin America, was even experienced at doing breech vaginal deliveries which is practically unheard of! But they worked with a hospital I wasn't crazy about for many reasons so I picked the midwife team instead. I can truely say that at this point I am happy with my choices and not scared of a hospital birth. I trust that if my care giveres intervene it will be because it is necessary. And my husband is comfortable which is important to me as well.
Posted by: Auburn | August 22, 2007 at 03:07 PM
Is it rude of me to post a comment without adding anything truly substantive? Cause I just want to point out what an incredibly civil and amazing discussion this is, and I would like for all of us to go out for breakfast if we could.
And Shandra, I'm so very sorry about the loss of your child.
Posted by: Lisa | August 22, 2007 at 04:55 PM
WOW. I have never seen such a thoughtful, articulate, respectful group of people, online or in person. Thank you all so very much for sharing your advice and your birth stories. Just being reminded by you all to bring everyone in as respected *partners* -- husband, doula, doctors and nurses alike -- instead of mentally gearing myself for an epic me/us vs. them birth battle -- is a big step for me towards resolution. I can't thank you enough for your kindness.
Posted by: Katie | August 22, 2007 at 06:04 PM
I haven't read all the comments (sorry!), but have you and your husband met with any homebirth midwives? This interview process would give you and your husband a chance to ask any and all questions you may have about homebirth, and it could make an enormous difference. Ask if they can give you some references, too -- my husband often fields phone calls from expectant papas with homebirth questions (he's on our midwives' reference list). I completely understand your need to have your husband's support, and I'm sure his vote of confidence (or not) makes a difference in your own confidence level, but the fact is that YOU are the one who has to birth this baby, and there is an awful lot at stake for you.
I wonder what your husband's underlying fears are? Someone who could help him articulate these -- maybe a midwife, or a counselor? -- might really help you both get to the bottom of this issue.
Wishing you all the best for a beautiful, powerful birth!
Posted by: Meg | August 22, 2007 at 06:56 PM
Okay, this part of the first comment was exactly my experience:
"Having read TWGtaBB, I knew to vehemently refuse having my water broken, which was offered "to speed things up" and which, in my case, probably would have led to a series of interventions I most definitely did not want. I knew that continuous fetal monitoring would not improve my day and might cause my labor to slow and cause scary but meaningless data to be used to justify doing things do me."
Except that I had all those things with the birth of my son - and I agreed to them - because I really wasn't informed about the reasons that breaking your water is a bad ide - leading in my case to pitocin, an epidural that was actually in the wrong place (and an anesthesiologist who did not believe that I could still feel things and so POKED ME with a needle to test me!), 27 hours of labor (incl 2.5 of pushing), an episiotomy that did get infected, placental hemorrhaging...
you get the picture. Despite the fact that eventually we were all okay (although I did probably have some PPD, and did have postpartum thyroiditis that destroyed my thyroid permanently), I was traumatized by my son's birth - and I think maybe the stranger part was that I didn't realize how much until I started thinking about number two.
I did quickly decide not to return to my OB/GYN - I know I agreed to the interventions, but part of it was that I physically could not return to the same hospital. I am lucky in that I live in the Boston area, with tons of hospitals to choose from...
On the advice of a friend, I went to the midwife she has used, who delivers at a small hospital with a birthing center. My first visit I literally broke out in hives just talking about my son's birth - and there were several things that impressed me - one was the time she took to talk with me - and the other was how seriously she took my anxieties and worries. She also referred me to a therapist who specializes in birth/pregnancy/postpartum issues. Over the past five months her support and my visits with her helped me understand where my fears were coming from and what steps I could take in my life (asking for more support from DH, creating a birth plan with a midwife, dealing with my mom in a more constructive manner, getting some exercise (yay T-Tapp, thanks moxie!).
I am now 7 weeks pregnant, and while I am way more anxious than the last time, I also feel more in control of my medical care - but part of that is a change in me to be more proactive. I am asking more questions this time around, now I have this amazing community to consult too (seriously Moxie, and all the regular commenters are amazing).
Just to summarize - I'm sure this was long - I highly recommend finding a therapist who specializes in pregnancy/birth - midwives will likely be able to give you a referral. And you are not the same mom who gave birth the first time - you are now a more educated and confident woman, and as other posters have said, speaking up and asking questions, and trusting your body and your husband will help you get through what will hopefully be a beautiful birth. Good luck!
Posted by: SJ | August 22, 2007 at 10:05 PM
Gotta side with hubby on this one. Don't assume that a second (or third) childbirth will be easier than the first!!! Mine have been progressively more difficult. My first childbirth was quite easy. Second required an episiotomy and still had fourth degree tearing. Third ended up being fully breech requiring a C-section, though the doctor had examined me numerous times and thought that the baby was head-down.
I'm all for mom being in control of the situation, but don't just look at the stats and assume that the statistical norm will always apply to you.
Posted by: Melanie | August 23, 2007 at 01:24 PM
A doula is the most wonderful thing to have for your birth. It means you can get on with doing what you have to do and someone with a level head can get on with protecting your wishes and interests.
I had a homebirth and lucky for me all was straightforward. I think our doula was key in convincing my partner that homebirth was a safe way to go and that it's easy enough to transfer to hospital at any time if need be. I didn't tell a lot of people (mainly family) that we were having a homebirth because I knew they would have just worried and perhaps tried to talk me out of it. I'm so glad I did it this way. I know your husband is probably just worried, but I wonder if there's any way to make him more comfortable with the homebirth thing. Or like has been suggested the birth centre option. Good luck in any event, hope you have the birth you want. xx
Posted by: Amberjee | August 24, 2007 at 09:05 AM
I have to respectfully disagree with the poster that said the father only has a philosophical stake in the decision and labor. And, maybe, yes, in the physical process of the birth and recovery, that is true. But, the father has a baby as well.
Posted by: k | August 25, 2007 at 01:13 PM
Is anyone still reading this far down? If so, here goes!
1) Shandra, you have my deepest, most heartfelt sympathies for the loss of your daughter.
2) IME most homebirth fathers didn't like the idea to start with. I think there is something more 'male' about wanting the process to be under the control of an 'expert' whereas mothers -- who certainly are just as invested in having a healthy baby! -- are more inclined to want to do it their way.
3) I don't know ANY fathers who were unhappy with the homebirth experience in the end. Most of them became ardent advocates of homebirth -- even the ones whose wives/partners had to be transferred to a hospital.
4) Meeting with homebirth midwives and talking with them was the key to my husband's acceptance of this option for ourselves.
5) Meeting my husband and seeing that normal people have homebirths was the key to my friend's husband's acceptance. lol He just needed to know that homebirth was for regular folks and not only hippie-granola-crazies.
6) Here's a story to show how planning a homebirth can SAVE a baby's life if things get into crisis mode. My dear friend was under the care of the same homebirth midwives I used. Their care includes hour-long appointments throughout pregnancy to not only check your pee and your vitals but to *get to know you.* When labor began, my friend was bleeding quite a bit, and soon the decision was made to transfer to the hospital. The hospital folks monitored the baby, did ultrasounds, observed, watched their vitals, etc. After 3 or 4 hours, they could not find anything wrong with her or the baby, figured it was just a bloody labor, and told her to go home and have her homebirth. (Homebirth is a fairly common occurrence where I live so the hospital people are familiar with it.)
Here is where the midwifery model of care came in. The midwives were watching and supporting this whole time (no hosp privileges so no actual medical care by them), and they recognized that something was wrong. My friend was feeling strange and acting strange and they knew that something was up. Her blood pressure was all wacky and she was feeling woozy and out of control. Apparently this did not raise the suspicions of the hospital OBs or nurses, but it did concern the midwives. These dedicated, devoted *homebirth* midwives insisted that my friend stay in the hospital, with them acting as doulas.
Shortly thereafter, the baby's heartrate crashed and my friend was whisked in for an emergency cesarean. It turned out that she had an almost complete placental abruption. Her baby might have died -- if she had not had attuned, attentive caregivers who knew how to read a PERSON and not just a monitor strip. The hospital was ready to discharge her less than an hour before! She wasn't very far dilated yet so even if she had been planning a hospital birth they would have wanted to send her home.
So many people who hear this story say, "Good thing she was in the hospital!" But that misses the point. It wasn't the hospital that saved the day, it was her midwives.
This is the power of the midwifery model of care: the complete knowlege of normal birth and the relationship they develop with each mother.
7) Bottom line, talk to some midwives who do homebirths, and to some people who have had them. Your husband may find his fears totally allayed.
8) In the end, if you do plan a hospital birth, let me join the "doula!" chorus!
Posted by: swimmermom | August 25, 2007 at 09:45 PM
We didn't have a similar dispute, but DH was less sold on the unmedicated birth than I was, until he actually went through the Bradley course with me. That convinced him that it could be done, and that we could do it. So my suggestion is, go through a course like that to learn how to NOT have to pioneer your own pain management, and to get hubby fully on board and knowledgeable in how to support you. Next suggestion...how about a midwife who works in a hospital (if there isn't a true birth center available)? I found that to be a good compromise: although I ended up with lots of interventions anyway due to pre-eclampsia, I had a highly experienced midwife who helped us try our best to do things the way we hoped, and didn't intervene until she really really had to. That way, I trusted her when she said, "Yes, I think it's really time to go to X intervention." We had the benefits of two different models of care; I trusted her, and she knew that we'd been through a good education to get there.
Best of luck to you -
Posted by: Kristin | August 26, 2007 at 09:18 PM
ok, I read the "30 minutes" to c-section comment and had to comment. I had no interventions whatsoever -- not even an IV, an incredible OB (trained by midwives)who tried everything to get my baby (face up, 8lbs, 8oz, huge head) out before going to c-section. He was going to do the epidural but my blood pressure dropped significantly, (very sudden) and the baby's heart rate dropped (they put a fetal monitor on baby's head when c-section decision was made). He was out in under 5 minutes, perfectly healthy about 10 minutes after birth. I had a perfect pregnancy, swam ever other day, gained about 35 lbs, had perfect blood pressure -- ideal. What was not ideal was a baby in the wrong position, a pelvis that was too small and a huge head on the baby. 5 minutes made the difference for us.
Posted by: Jb | August 27, 2007 at 06:42 PM
Just wanted to second the person who said fathers can completely come around on homebirth. My husband had never heard of it and he is Mr. Safety who tends to the go-to-the-experts view. But he knew my feelings on the subject and my family tendencies (Mom is a midwife and sisters have theirs at home) so he went along for the ride, often uneasily, read The Birth Partner and timed the drive to the hospital.
Well, he was a total champ at the birth and is now an educated advocate. I had to laugh the first time I heard him comment on some birth-related news story with something like, "Well, that's because they do so many c-sections!" My convert! I'm so proud. :P
Posted by: Chiara | August 31, 2007 at 02:19 AM
we had a dispute for a while. DH was very anti homebirth for safety issues. But over the course of the pregnancy he came to realize that in a hospital birth center - the best in N. Ca according to many - we still couldn't have the birth I wanted. It came down to, I was so peeved with the regulations that I was seriously considering an unassisted homebirth. At which point, DH decided it was time to call the homebirth midwives. =) That and my pretty much saying, hey its my body and its been violated before (I was kidnapped and assaulted years ago), and frankly, if you want to go to the hospital you go right ahead, I am staying here. PPD wasn't worth it to me - and I truly believe that I would have ended up with PTSD issues. So in my 7th month, we transeferred to a homebirth midwife. It was like coming home literally. 2 hour appointments instead of 15 to 20 minutes. The acknowledgement that we were birthing a family, not just a baby.
My birth went like clockwork. Sort of. No first stage, waking up at 4 am with contractions 2 minutes apart. The midwives arrived within 10 minutes, and down to business. My 8 lb, 10 oz son was born with no painkillers, at home, where we wanted to be. No tears, no skid marks, no dangers. A bit of protracted pushing that would not have been allowed in the hospital.
Its not for everyone, I know. I applaud the CNM's that work in hospital and birthing centers for attempting to make birth a more woman-friendly enterprise. They ride a fine line. As noted in comments above, alot of the dangers have to do with innapropriate monitoring. The average labor and delivery nurse is monitoring up to 9 patients at a time. In a homebirth, there are usually two midwives per birth - one to monitor mom and one to monitor baby. That means that the vast majority of issues are noted long before they turn into something major. And the things that can't be changed? Really, they wouldn't be any better in the hospital setting. And often would be worse.
My heart goes out to those that lost babies through whatever happened. And also to those women that suffer in silence their birth-related PTSD and PPD, or that find parenting difficult due to that. Hopefully, we will all be able to find the education and self empowerment to make the best choices for ourselves, remembering that we are the vessel that brings forth life. While our husbands are the fathers, they will not have to life with the psychological consequences of the birth process. Only we can change the system to one that empowers us and respects our choices, whatever they may be.
God bless!
Posted by: Tiny | August 31, 2007 at 03:54 AM
I don't know your special stiaution. Maybe you have other reasons that I never had and that I can't understand.I'm not saying you shouldn't do it. But I do say If there is the tiniest chance you would regret it in the middle of everyting.. if there is any possibility you will doubt you did the right thing you shouldn't do it.But if you are 100% sure and have the confidence to convience both yourself and the people around you that this is how you want it I think you can do it and you will probably have a wonderful experience.I know this is a very long reply.. but I'll just add about the pain relief.. I have always wanted to give birth without. But at the first one I gave up on the midwive's recommendation after 15 hours and only two tiny centimetres open. I was exhausted and nothing happened. So I ended up with epidural.The other two I gave birth to without even considering taking something.. it just went a lot smoother..From now on your blog is in my RSS.. I wanna see how everything goes. :)
Posted by: Lee | July 27, 2012 at 03:30 PM
I want to go completely nrtaual (no drugs, ideally at a birthing center, but the closest one is 15 miles away from me whereas the hospital is 5), but I'm not sure about my pain tolerance. I've never had any big accidents, broken bones, etc. so I'm not sure I can deal and I don't want to panic when it's too late.My mom had me w/out any drugs, so maybe that's why I feel like I want to do it, too.
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