Should I have a home birth? How we made our choice.

Benjamin was born eighteen minutes shy of his sisters birthday, six years later. It was Saturday evening. The house was quiet. Our cat Sonata paced below my fingertips, eager to see what all the fuss was about. Andrew was there, close enough for me to hear him repeat, "You've got this, you're doing great," but he didn't touch me. He knew I needed to do this on my own. Not because I needed to prove something, but more because I was trusting in myself, in my body, in my midwives.

"I've read so many different coping books," I told my midwife one sunny morning in her Brockville office... "Is there one method you find really works?" I asked, hopeful it would be one of the books I'd already read... (but at the same time not loving any of the methods).

She smiled in her reassuring way and gave me an out. "I find that women do best when you just leave them alone."

That was the most useful piece of advice regarding childbirth that I'd received to date. So useful in fact, that I toy regularly with how best to impart this newfound empowering freedom to other expecting mothers.

But let's rewind for a moment because I can’t talk about Ben’s home birth and our reasons for choosing that route without first telling you about our twin birth experience. It took place in the operating room of a hospital, with stir-ups and gowns and twenty other people.

Twins is a whole different game in the pregnancy world. There's a fear element present that took until I was 20 weeks pregnant with our singleton son to dissipate. I had to do a lot of letting go quickly. Some things were humorous, like letting go of the Oeuf crib I had my eye on because two $800 cribs would be outrageous. Other things were harder to let go of. Like all the midwives I'd called when I first found out I was pregnant. None of them were willing to take me after finding out the nature of our twin pregnancy. Twins are risky. Our daughters were mono di twins, meaning they shared a placenta. I had an ultrasound almost every single week of my pregnancy. There was an ever-present concern that they would come early.

I was followed by an obstetrician who was fairly good natured but measured success in small goals. If I made it to 30 weeks we could start celebrating. He laughed when I told him I planned on refusing all medical intervention and remained quiet when I told him I was contemplating writing Don't cut me, on my stomach. And I say that not to offend anyone - because I understand that there are medical reasons that warrant belly births. I just didn’t want one for a convenience factor. A this is too complicated because you’re having twins factor. Little did my OB predict, but I made it past due and delivered our twins vaginally. While I had hoped for a medication free birth, I did eventually get the epidural. I found pain management in the hospital with a double monitor around my contracting belly and no allowance for freedom of movement, very challenging. I vividly recall wondering whether I could die from the pain of throwing up and contractions combined - but when Alice and Isla arrived, I rejoiced in the fact that they laid each one on my chest. One small victory in a sea where I felt I had very little control.

At the time, even given the medical interventions I allowed, I was still pleased with their birth. When we used our frozen embryo and I ended up pregnant with our son, I called that same obstetrician's office and made an appointment.

Walking down the halls of the hospital again overwhelmed me with memories. The sharp smell of bleach, the familiar ding of the ancient elevator, the same woman smiling up at me from behind the desk.

They remembered me. They reviewed my charts. They reminded me of the serious hemorrhage I had after the twin birth. They talked to me about the possibility of having pre eclampsia again. I asked my OB if he thought my cervix shortening would force me into bedrest again. He didn't know. I took it all in and assumed I would end up back at the hospital, delivering with whichever OB was on call that night.

But this time my appointments were not weekly. I had time to breath in between. I had time to think. I was tired but exercising daily, happy but feeling like something wasn't quite right.

Then I went for our twenty-week ultrasound. This was the week of the anatomy scan and when they would check to see if my cervix was shortening like it had with the twins.

Everything was normal.

I remember going home and sinking into our armchair. I remember the flood of relief that things seemed to be going down a less risky path this time around. And then I remembered that time, early on in our twin pregnancy when I searched for a midwife.

I called Andrew and told him that I wanted to try and find a midwife to take me. He was supportive but joked about not having a home birth. I agreed. I would try to find a midwife with privileges at the birth centre. A happy compromise.

I do not recommend waiting until you are twenty weeks pregnant to find a midwife. Call the second you are pregnant. I was so lucky that Generations Midwifery shuffled their schedules so that they could take me on as a patient.

I drove forty minutes to their office. It was the same amount of time as my drive to my former OBs office, but this felt so very different. Instead of traffic, six story parking garages and constant worry whether everything would be okay with the babies, there were clear roads, free parking and excitement.

The sun shone through the windows and heated the chaise lounge that replaced a typical doctor's exam table. I met one of my midwives. She was warm and confident and I felt immediately at ease in her presence. I voiced our desire to give birth at the birth centre and she said that was great if that is what we wanted. She then told me that many of her intended birth centre births end up as home births. Her reasoning was that the midwife meets you at your home first to see how things are going when you are in labour, and then you leave for the birth center when you are close enough to delivery. Often women decide they are comfortable where they are (and skipping a trip in the car while managing contractions is a welcome bonus).

I went home and started reading books. I re-read Ina May's Guide to Childbirth. I skimmed the Bradley Method, I considered joining a hypnobirthing class. I asked Andrew what he thought of a home birth.

 

If it's what you want, I will support you. He answered.

And it was what I wanted. I decided that same day.

The next appointment, I met another one of our midwives. I pulled up a list of questions I had written in the notes section of my phone.

Is it risky to have a home birth when we live so far away from a hospital?

No, she responded. Midwives only attend home births under low risk situations. They monitor each situation and defer to a hospital birth if the situation becomes risky.

What happens if I hemorrhage at our home birth like I did during our twin delivery?

They carry the same anti hemorrhage medication on hand that they have in the hospital. She could even run a line just in case (I did not opt to have the line run).

What happens if the baby has a blue episode like Alice had at the hospital, the same day she was born?

They bring something to suction the mucus out of their lungs and they can show us what to do if that happens after they leave.

Finally, what do we need to have in our home for a home birth?

Not much. Lots of old towels, some plastic sheeting and a container to put the placenta in. They would bring the rest.

A few weeks later Andrew and I attended a birth choice information seminar put on by our midwives. They showed us video footage of a home birth (we'd already watched a bunch and even showed our children them too as we were completely open about the IVF process with our twins who were five at the time, and they were curious to learn all about birth). Our mind was already made up. My views on birth were once again changing and I was eager to explore this different approach.

Immediately after Ben’s birth I felt this sense of sadness for the me that delivered our daughters in such a fearful state in the hospital. For me, our home birth felt like such a powerful experience compared to the utter feeling of uncertainty at the hospital. In many ways, I feel like I came full circle.

Birth is life changing no matter how you do it and my intent with this essay is not to shame any birth choice or situation. I am here to share my personal experience and Ben's home birth was one of the best experiences of my life.

Stay tuned for my next post around birth later this month: How Messy is a Home Birth?

If you have any questions about home birth or our twin hospital birth, please leave me a comment or send me an email.