My hospital births in Seattle
A long time ago and far away in the city of Seattle, I used to be a non-hippie who knew that home birthing is silly and dangerous. When I learned I was expecting for the first time, I found a cute old man to be my obstetrician and deliver my baby at the hospital down the street. He talked me into an AIDS test (an exercise in wasting money), induced me unnecessarily, and gave me an episiotomy just for fun. But, after wandering up and down the hospital halls with my rear end hanging out, a tube stuck in my arm, and tears rolling down my cheeks, I was able to deliver without any complications and without an epidural. I thought my birth had gone beautifully!
My second baby was also born in a hospital. This time I went into labor on my own and stayed home as long as possible so as not to annoy the admissions nurse, who hadn’t been too friendly on the phone. Finally, I knew I couldn’t reasonably wait any longer, so I went to the hospital, where I labored in the waiting room while the nurses searched for an empty bed. After pacing in the waiting room for thirty minutes, I informed a nurse that I had the urge to push. When I said that, an empty bed magically appeared just a few doors down the hall. The nurses put me in a wheelchair, zoomed me to the room, and ordered me to change my clothes and lie down on the bed where I popped out baby number two. All of this took ten minutes, and 24 hours later I was back home, glad to be away from those nurses who never would let me sleep.
I move to Sequim, Washington, land of the hippie births
After baby number two was born, we moved to Sequim, Washington, a little town that is an hour’s drive plus a ferry ride from Seattle. Sequim is home of the Irrigation festival, a Spring-time celebration that includes a grand parade down our main drag. My first Spring here, I took my little girls to see the marching bands, horses and tractors. Also in the parade was a home birthing group, a ragtag group of women with fertile figures pushing their babies in strollers. The babies held signs saying, “My first hug was at home.” Shuffling along beside them, playing ukuleles, were their skinny fathers. Being the hard-nosed, conservative type, I don’t care much about hugs, so my friend and I mocked the home birthing group, and I never gave a moment’s thought to the fact that I have a fertile figure and a skinny husband who plays a mean ukulele.
As I said, though, I am a hard-nosed, conservative type. So when baby number three started growing in my belly, I started punching numbers. Even with decent health insurance, I knew I’d be paying a hefty portion of my birthing bill. So I called up the local hospital to find out how much they charge for a vaginal birth without any complications and without an epidural. That’s when I learned that medical billing is not a good profession for those who like hard facts and figures. No one at the hospital could tell me how much a normal birth would cost; but, with a little persistence on my part, they finally uttered a rough guess of at least $10,000.
Ten thousand dollars! With a co-insurance of 20%, I would be paying about $2000. Two thousand dollars of my husband’s hard-earned money! This is when I started having nightmares about paying $10,000 for a doctor to (1) watch me cry and (2) ask my husband if he’d like to cut the cord. (You’d think that for $10,000 they would throw in the cord-cutting service without any questions asked.) Of course, this $10,000 also paid for the nurses to (1) throw out the placenta, (2) change my sheets and (3) torture me with uterus massages and blood pressure checks.
I know it’s un-American to think about the cost of one’s medical care. But I have yet to buy into the idea that no medical risk is too improbable to pay thousands of dollars to avoid. And so I figured, since I didn’t have any extra money lying around, I might as well be un-American. I started contemplating whether there might be a cheaper way to have a baby, and I had the good fortune of mentioning this to my neighbor who suggested home birth. I said something profound about not wanting to take such a risk. “Well, there are risks with having a baby in the hospital too,” she replied. My first thought was MRSA. My second thought was cute old men. If I kept on having babies in hospitals, at some point a cute old man would probably get antsy, or maybe just bored, and order a caesarean. “Just how risky is a home birth?” I began to wonder.
I enter the land of hippie birthing
My neighbor gave me her midwife’s number and I called her. Later, I talked to another midwife, read some books and watched a movie. I had entered the world of hippie birthing, and I learned oh so much! Some of the key facts for me were:
A. A home birth costs less than half of what a hospital birth costs.
B. Home-birth midwives only provide care to women with low-risk pregnancies, which is about 80% of all pregnancies.
C. Midwives bring medical equipment to your house, such as IVs, oxygen for resuscitating a baby, pitocin for hemorrhaging, needles to stitch up your tears, etc.
C. They are not able to give pain medication or perform a caesarean.
D. My rural hospital’s caesarean team is an on-call team, meaning they are within 20 minutes of the hospital, which is also how far I live from the hospital.
E. A recent study in British Columbia showed that home births are no more risky than hospital births (home birthers are a healthier population set, which was accounted for).
F. Home birth midwives recognize that hospitals and obstetricians are necessary, and are prepared to send a woman to a hospital if a labor should become prolonged, making pain medication advisable, or if an emergency should arise.
If you want to research home birth, I suggest watching the movie titled “The Business of Being Born,” and reading “Ina May’s Guide to Childbirth.” Ina May’s book includes a lot of birth stories (which I found boring after a while) and a really strange chapter about pleasurable births (as far as I can tell, this chapter is fictional). But there were several chapters I found extremely interesting and
informative. These chapters covered the history of midwifery and obstetrics and the scientific research behind current birthing practices. I won’t go into detail here, but I learned what I had already intuitively known after two hospital births: that many of the birthing practices in American hospitals are not based on scientific research, but on tradition and convenience for the hospital or doctor. Simply put, much of what happens in labor and delivery rooms is bad medicine.
I find peace and joy in the land of hippie births
After I had found a midwife who would take my insurance (and was good with hard facts and figures too!), I set out for my first prenatal appointment. I drove to the Victorian seaport town where she has her practice. I walked down a brick path through a garden to her cottage clinic. I removed my shoes to pad softly across her immaculate carpet to the bathroom where I used lavender soap and drank water with lemon. There were no other patients there, and my midwife spent an hour with me. In addition to getting a urine sample and weight check, measuring my uterus and taking a blood sample for the lab, she answered my questions and made pleasant conversation in a manner that suggested she had all the time in the world. Every consent form she gave me included literature explaining why the test or procedure became routine and the statistical risk involved. She let me read the material at home and decide whether I wanted the procedure. A large portion of routine prenatal care is to prevent problems caused by sexually transmitted diseases; I chose to skip all those, and no one minded.
Other than not having to wait, not being pressured into unnecessary tests, and getting a hug goodbye, the prenatal care for home births is about the same as prenatal care for hospital births. A midwife can order all the same tests that doctors order, including an ultrasound. Near the end of my pregnancy, though, my care became very different from mainstream care. A month before the birth, the midwife came to my house to make sure my home was adequate for the delivery. She checked to make sure I had basics, such as running water and reliable heating, and that I keep it clean. She made sure I had gathered the supplies on a list she’d given me, such as a thermometer, chucks pads, wash cloths, garbage sacks for laundry, receiving blankets, and a pan to catch the placenta. She asked about my plans for getting post-partum help from family and friends.
A few weeks later, my due date came and went. While I was getting antsy, the midwife didn’t seem to mind at all. She told me all the ways I might try to induce labor at home and which of those methods had been scientifically proven. Finally, I did go into labor. As every mother knows, trying to figure out when to go to the ospital is not easy. With home birth, it’s a similar challenge: figuring out when to have the midwife come over. With home birth, though, your practitioner remembers you and your history and is willing to talk to you on the phone. Also, there’s no risk of delivering on a freeway. After my midwife and I decided together that it’s time, she notified her assistant, and then put on her purple T-shirt and white overalls. She braided her beautiful graying hair, pinned it around her head and drove to my house, where she was prepared to stay a long time.
While she was on her way, I was spreading shower curtains on the floor to protect my carpet from blood and water. My bed was made with a set of sheets, a shower curtain, and then another set of sheets. After I had delivered, we would toss the dirty sheets in the laundry, the shower curtain in the garbage, and underneath would be a fresh, clean bed waiting for me and the baby.
In the land of hippie births, once you’ve spread the shower curtains, you can labor however you want. You can eat, sleep, watch a movie, frantically scrub your bathrooms, lie on the bed and moan, whatever. Unlike doctors, midwives do more than show up when you’re about to push or about to die. They stay with you through the labor, patiently watching and waiting, and occasionally checking you and the baby. No one threatens you that if you don’t hurry up and pop out your baby, then they’re going to cut you open and do it themselves.
When you are ready to pop out the baby, you can do it lying down, standing up, kneeling (my choice), in the bed, in the tub or on the kitchen table. And if you scream and swear that next time you’re doing it in the hospital with an epidural, they don’t seem bothered. In interest of full disclosure, I will state that pushing a baby out without numbing medication is horrible, agonizing, H-E-double-hockey-sticks kind of pain. Your chance for a smooth birth without complications, though, is much greater. And once the baby’s out, your relief is akin to joy. Also, you aren’t numb; you can get up and walk to your shower. Furthermore, you don’t have to pay an anesthesiologist thousands of dollars.
After the baby is out, and you’re all checked and cleaned up, the midwife gets ready to go. First, though, she gives your husband instructions to check you and the baby every four hours to make sure you’re recovering normally. Then she tells your husband something very wonderful: don’t set the alarm. In other words, the midwifery school of thought is that a new mother probably needs sleep even more than a temperature check. Brilliant! After that, an even more wonderful thing happens. The midwife schedules her post-partum home visits. You don’t have to shower, dress and load up your baby two days after giving birth. You can stay in your pajamas. In fact, you can stay in bed, and she will come to you.
By the time the midwife has said all these wonderful, brilliant things, you have noticed that your abdominal skin is no longer stretched to impossible proportions. You revel in the relative flatness of your belly. Your birthing cramps are fading, and you are getting sleepy. Beside you is the most amazing, brand-spankin’ new baby the world has ever seen, swaddled into a ball of contentment. Just beyond her is her wonderful daddy who is getting sleepy too (his ukulele is down the hall in the living room). You realize that you are in the joyful, peaceful land of hippie birth, and when your midwife leans down to hug you goodbye, you discover that even hard-nosed conservative types can learn to appreciate hugs.