On Giving Birth at Home

Several women have asked me about my experience giving birth to Silvan at home, and I've been thinking a lot about home and hospital births throughout this past year. I have been really amazed at how politicized the act of giving birth has become. Many people I encountered during my pregnancy were sure that I was placing myself in danger by giving birth at home, and others expressed a fear of lost control and chemical and surgical interventions that could be equally dangerous in a hospital setting.

When I became pregnant with Silvan, I knew right away that I wanted to have a natural birth at home in the old way of women around the world throughout history, and that I also wanted to take advantage of the safety net of modern medicine. I sought out a midwife locally, and was surprised to find that, for legal reasons, midwives do not give out their contact information to potential clients until after an initial meeting. I had not thought much about the legal status of midwifery in 21st century America until I went through this experience.

I enlisted the help of a midwife who has delivered over 500 babies without serious incident, but who has, in her own words, "not a leg to stand on, legally". This wonderful woman was my primary source of support throughout my pregnancy, and provided me with advice, comfort, and care that I cannot imagine receiving from a doctor. She was willing to come visit me at short notice just to quell my fears or talk, and spent hours reassuring me on the phone. She assured me, at each meeting, that my growing belly was beautiful, that my baby and I were thriving, and that my body was designed to give birth, the most natural thing in the world, and nothing to be afraid of.

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My midwife is lucky to have a backup doctor who truly supports the ancient practice of midwifery. Maybe his Lebanese upbringing has given him a broader sense of the experience of birth than is typical. He encouraged me to trust my midwife's judgment, but also offered me the option of an array of medical tests and procedures. I noticed that he was somewhat constrained by the fear of litigation and liability that seems to plague the medical community, and his medical advice tended to follow the guidelines of the AMA. My midwife had a good deal of freedom as a side effect of her lack of legal status, and her prescriptions stemmed from her experience and common sense. I felt that her body of knowledge was the old, and time-tested, knowledge that women have of childbirth. I was also grateful for the many tests and ultrasounds I received at the medical clinic, but I always had a sense that this is a very new way of handling birth. I found myself wondering, often, about the potential side effects of medical treatments only a few years old.

I went into preterm labor at 32 weeks and spent a day and night in the hospital. This experience cemented my decision to give birth at home. There is something comforting about handing yourself over completely to people who are trained to take care of you in an emergency, and I'm glad to have access to the Bloomington hospital for medical help. But I do not consider pregnancy and birth to be medical conditions, and found it very disturbing to be cared for by strangers who were primarily concerned with hospital protocol and liability. I found myself confined to a hospital bed long after my contractions had ceased, in the care of a series of nurses whose skill levels varied from complete incompetence to great kindness and efficiency. I left the hospital feeling depleted, weak, and scared-- too many people had given me the message that I was in danger.

I fought against my fears throughout my pregnancy. I was diagnosed with many obscure conditions, all potentially dangerous; fibroids, gestational diabetes, group b strep. My midwife reassured me, each time, that these conditions were newly discovered and statistically unlikely to cause complications. With each new test, it seems, there is a new set of things to fear and fight with medical interventions or antibiotics, and more reasons to view birth as a hazardous medical condition rather than a natural process. I had to move past my fear many times, to trust the women's voices around me and temper the authoritative voice of medical science.

Silvan was a week overdue when my water broke, and a day passed after that before I went into labor. During this time I tried to come to terms with the possibility that I would need to go to the hospital for an induction. I had heard that the contractions caused by pitosin would be unnaturally strong and close together, and that I would be more likely to need an epidural as a result. Several friends who had attended hospital births suggested to me that I may not be aware of what drugs were being administered to me through an IV, and that I would need an astute advocate present to monitor what I was given. Other friends of mine who had given birth using an epidural had told me that they felt strangely passive during their births, and had to be told when to push and physically manipulated into moving the baby during labor. I knew that I wanted to be present during the birth, and an active participant in my own labor. I did not want to be lying down, or confined to a windowless room, or in the presence of strangers. I did not want to be acted upon. I had read that the introduction of one medical intervention, such as pitosin, frequently leads to others; induced labors often necessitate epidurals, and more often lead to cesarian births. I was really scared of giving birth in this environment, where I felt I would have to fight for control over the situation while I was in a particularly vulnerable state.

Silvan must have sensed my fear, because I started feeling regular contractions early in the morning on Friday, June 27. I could tell I was going into labor when my senses became strangely heightened-- a vase of wild roses on the bedside table vibrated with pink, and burning sage was intensely heavy in the air. Bruce filled the house with wildflowers for Silvan's birthday as I tried to keep myself distracted through the milder early contractions. My midwife came to the house, took off her shoes, and arranged her things in the living room, all very quietly, while I sat on the couch breathing through my contractions. She was a quiet presence there with me for the next several hours. Her assistant came later, and silently added her energy and support to the room. Without speaking, they would bring me water, hot compresses, cold clothes for my forehead. The presence of these women at the edges of the house was so comforting to me. They were there to help me, but respected that I was the one giving birth.

Occasionally, when I had been laboring for some time without much progress, my midwife would suggest a change of position to speed things up. Other times, I would ask her for a way to make the contractions less intense. I spent some time in the bathtub, with Bruce pouring hot water on me. When I was fully dilated, my midwife moved me to a birthing stool she had brought, which allowed Bruce to sit behind me, supporting me. I really felt him with me, breathing with me and helping me find the low, deep growl that would help me push Silvan out. I felt like we were giving birth together. My good friend Catina came to the house at this time, and lit the candles and sage on the altars to get the house ready for Silvan's arrival. I was surrounded by these three beautiful women, sitting around me in a circle of good energy and support, moaning with me, encouraging me, while the summer wind blew the lace curtains around and the cats came in and out of the house, watching. In this way, Silvan was born.

I will never forget the feeling of him leaving my body, the whole length of him turning and slipping out of me and into the world. He came out strikingly blue-violet, like Krishna, with the cord around his neck and his eyes wide open. I never saw how quickly my midwife freed him from the cord and got him breathing-- by the time I was aware that he was in danger, we were tickling his feet, talking to him, and he was pinking up and starting to cry. I pulled him onto my chest right away, and he learned to breastfeed within a few minutes of being born. The women bustled around the house, checking my bleeding and his breathing, cleaning us up, and turning the house back into the place it had been before the birth. I saw my midwife dabbing at the furniture with hydrogen peroxide to remove the bloodstains, and doing a load of laundry. Catina walked around the yard playing a wooden flute. We all ate some spinach lasagna I had made, and laughed and talked with joy and relief. Everyone agreed that Silvan is particularly beautiful. I took a bath and Bruce and I went to bed with our new baby.

I would not trade the experience of giving birth in this way for anything. My midwife has five children, and assures me that part of being a mother is experiencing pain-- to bypass the pain from the beginning, she says, is to deny much of what is ahead. I feel that I've pushed past a lot of my fears, had to trust myself and my body, and opened myself up, physically and spiritually, as wide as I can. I've gone to a place where I thought I couldn't go further, and I've gone further. I can't imagine any better preparation for being a mother than that.